ESSENTIA HEALTH SPOONER CLINIC
NPI 1083161301
Clinic/Center - Rural Health in Spooner, WI
About Essentia Health Spooner Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ESSENTIA HEALTH SPOONER CLINIC (NPI 1083161301) is a healthcare organization registered as a rural health in Spooner, Wisconsin and active in the NPI registry since September 2016. The organization holds an CLIA Accreditation certificate valid through April 17, 2028 and lists Kevin Boren, Vp Of Finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Essentia Health Spooner Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
381Medicare enrollment records show 381 clinicians reassign Medicare billing to Essentia Health Spooner Clinic, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 45
Nearest to this location (20)
See all 381Superior, WI 54880
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 52D0396920
Essentia Health Spooner Clinic · Spooner, WIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is St Mary's Hospital Of Superior's NPI number?
The NPI number for St Mary's Hospital Of Superior is 1083161301. It was assigned to this organization in the NPPES registry on September 2, 2016. The provider is doing business as Essentia Health Spooner Clinic.
Where is St Mary's Hospital Of Superior located?
St Mary's Hospital Of Superior is located at 1180 Chandler Drive, Spooner, WI 54801. The listed phone number is (715) 635-2151.
What is St Mary's Hospital Of Superior's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is St Mary's Hospital Of Superior enrolled in Medicare?
Yes. St Mary's Hospital Of Superior is registered in the Medicare PECOS enrollment system.
When is St Mary's Hospital Of Superior's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Wisconsin, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through St Mary's Hospital Of Superior?
According to the CMS Revalidation Reassignment List (October 2026 release), 381 clinicians in 45 Medicare specialties reassign their Medicare billing to St Mary's Hospital Of Superior. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (93), Emergency Medicine (56) and Family Practice (32). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does St Mary's Hospital Of Superior hold a CLIA laboratory certificate?
Yes. A Certificate of Accreditation (number 52D0396920) is associated with this NPI, valid through April 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does St Mary's Hospital Of Superior accept?
Health plans from Anthem Blue Cross and Blue Shield, HealthPartners, Sanford Health Plan and Security Health Plan list St Mary's Hospital Of Superior as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for St Mary's Hospital Of Superior was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Essentia Health Spooner Clinic · NPI 1083161301
Rural Health organization in Spooner, Wisconsin. Organization record, active in the CMS NPPES registry since September 2, 2016.
## Identity
- **NPI:** 1083161301 (Entity type: Organization)
- **Enumerated:** September 2, 2016
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** St Mary's Hospital Of Superior
- **Organization subpart:** Yes (part of Essentia Health)
- **Authorized official:** Kevin Boren, VP OF FINANCE
## Practice location
- **Address:** 1180 CHANDLER DRIVE, Spooner, WI 54801
- **Phone:** (715) 635-2151
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Wisconsin, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 381 clinicians in 45 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (93), Emergency Medicine (56), Family Practice (32); 4 practice within 10 miles; [full list](https://npiprofile.com/npi/1083161301/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1083161301) · Data from the CMS NPPES public registry.