ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC
NPI 1548604309
Family Medicine in Lake Park, MN
About Essentia Health St. Mary's - Lake Park Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ESSENTIA HEALTH ST. MARY'S - LAKE PARK CLINIC (NPI 1548604309) is a healthcare organization registered as a family medicine in Lake Park, Minnesota and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through August 19, 2028 and lists Alan Hurley, Coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 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 St. Mary's - Lake Park 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
254Medicare enrollment records show 254 clinicians reassign Medicare billing to Essentia Health St. Mary's - Lake Park Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 39
Nearest to this location (20)
See all 254Source: 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 Waiver 24D2309672
Essentia Health St. Mary's-Lake Park Clinic · Lake Park, MNFrequently 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 Regional Health Center's NPI number?
The NPI number for St. Mary's Regional Health Center is 1548604309. It was assigned to this organization in the NPPES registry on April 24, 2013. The provider is doing business as Essentia Health St. Mary's - Lake Park Clinic.
Where is St. Mary's Regional Health Center located?
St. Mary's Regional Health Center is located at 1005 1st St, Lake Park, MN 56554. The listed phone number is (218) 238-5901.
What is St. Mary's Regional Health Center's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is St. Mary's Regional Health Center enrolled in Medicare?
Yes. St. Mary's Regional Health Center is registered in the Medicare PECOS enrollment system.
When is St. Mary's Regional Health Center'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 (Minnesota, 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 Regional Health Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 254 clinicians in 39 Medicare specialties reassign their Medicare billing to St. Mary's Regional Health Center. 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 (91), Hospitalist (19) and Family Practice (17). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does St. Mary's Regional Health Center hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2309672) is associated with this NPI, valid through August 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does St. Mary's Regional Health Center accept?
Health plans from Sanford Health Plan list St. Mary's Regional Health Center 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 Regional Health Center was last updated on March 1, 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 St. Mary's - Lake Park Clinic · NPI 1548604309
Family Medicine organization in Lake Park, Minnesota. Organization record, active in the CMS NPPES registry since April 24, 2013.
## Identity
- **NPI:** 1548604309 (Entity type: Organization)
- **Enumerated:** April 24, 2013
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** St. Mary's Regional Health Center
- **Organization subpart:** Yes (part of Essentia Health)
- **Authorized official:** Alan Hurley, COO
## Practice location
- **Address:** 1005 1ST ST, Lake Park, MN 56554-4311
- **Phone:** (218) 238-5901
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Minnesota, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 254 clinicians in 39 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (91), Hospitalist (19), Family Practice (17); [full list](https://npiprofile.com/npi/1548604309/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 1, 2024
- **Other identifiers:** Medicaid 892442000 (MN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1548604309) · Data from the CMS NPPES public registry.