MEDICARE: CENTRACARE SURGERY CENTER, LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1861538613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRACARE SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	1900 CENTRACARE CIR
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-5000
Country	:	US
Telephone Number	:	320-229-4964
Fax Number	:	320-229-5171

Provider Business Practice Location Address
First Line	:	1900 CENTRACARE CIR
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-5000
Country	:	US
Telephone Number	:	320-229-4964
Fax Number	:	320-229-5171

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	01/26/2026

Similar Medicare Providers

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:

1407858020 — CENTRACARE CLINIC
Practice Location Address:

1900 CENTRACARE CIR , CENTRACARE CLINIC HEALTH PLAZA
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-252-2422
Practice Fax:

1225030844 — CENTRACARE CLINIC
Practice Location Address:

1900 CENTRACARE CIRCLE , CENTRACARE CLINIC-WOMEN & CHILDREN
ST CLOUD, MN
56303-5000

Practice Phone: 320-654-3630
Practice Fax: 320-654-3667

1487644134 — JEANNE M NOTSCH CNP
Practice Location Address:

1900 CENTRACARE CIR
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-229-4917
Practice Fax: 320-229-5181

1992795652 — DOUGLAS J WATKINS M.D.
Practice Location Address:

1900 CENTRACARE CIR
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-229-4917
Practice Fax: 320-229-5181

1366432015 — KATHRYN A MECHELKE MD
Practice Location Address:

1900 CENTRACARE CIR
SAINT CLOUD, MN
56303-5000

Practice Phone: 320-229-4917
Practice Fax: 320-229-5181

Directions to “CENTRACARE SURGERY CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.