MEDICARE: CENTRACARE HEALTH SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital	330997	MN
2	282NC0060X	Critical Access Hospital	331051	MN
3	291U00000X	Clinical Medical Laboratory	24D0405790	MN
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	273Y00000X	Rehabilitation Hospital Unit	331506	MN
6	311500000X	Alzheimer Center (Dementia Center)
7	251E00000X	Home Health Agency	331506	MN
8	273R00000X	Psychiatric Hospital Unit	331506	MN
9	275N00000X	Medicare Defined Swing Bed Hospital Unit
10	310400000X	Assisted Living Facility
11	261Q00000X	Clinic/Center
12	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
13	251G00000X	Community Based Hospice Care Agency	331506	MN
14	261QA1903X	Ambulatory Surgical Clinic/Center
15	282N00000X	General Acute Care Hospital	331506	MN

General Provider Information

NPI Number	:	1215118989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRACARE HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	1406 6TH AVE N
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-1900
Country	:	US
Telephone Number	:	320-240-2102
Fax Number	:	320-656-7099

Provider Business Practice Location Address
First Line	:	1406 6TH AVE N
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-1900
Country	:	US
Telephone Number	:	320-240-2102
Fax Number	:	320-656-7099

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL BLAIR
Credential	:
Telephone Number	:	320-255-5665

Provider Enumeration Date	:	11/21/2007
Last Update Date	:	01/26/2026

Similar Medicare Providers

1326097833 — CENTRACARE HEALTH SYSTEMS
Practice Location Address:

1406 6TH AVE NORTH
SAINT CLOUD, MN
56303-1900

Practice Phone: 320-251-2700
Practice Fax: 320-255-5711

1861538613 — CENTRACARE SURGERY CENTER, LLC
Practice Location Address:

1900 CENTRACARE CIR
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-229-4964
Practice Fax: 320-229-5171

1295586352 — LINDSAY MARIE GUNDERSON PA-C
Practice Location Address:

1900 CENTRACARE CIR STE 500
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-253-2663
Practice Fax:

1518839182 — JESSICA GAPINSKI
Practice Location Address:

1406 6TH AVE N
SAINT CLOUD, MN
56303-1900

Practice Phone: 320-229-4950
Practice Fax:

1003815051 — JENNIFER J ROGAN MD
Practice Location Address:

1900 CENTRACARE CIRCLE , CENTRACARE CLINIC WOMENS & CHILDRENS
ST CLOUD, MN
56303

Practice Phone: 320-654-3630
Practice Fax:

1336149939 — RALPH E FEDOR M.D.
Practice Location Address:

1406 6TH AVE N
SAINT CLOUD, MN
56303-1900

Practice Phone: 320-255-5619
Practice Fax: 320-656-7068

Directions to “CENTRACARE HEALTH SYSTEM ” Practice Location

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