ESSENTIA HEALTH ST. JOSEPH'S-PINE RIVER CLINIC
NPI 1649223603
Clinic/Center - Primary Care in Pine River, MN

Active since May 18, 2006CLIA 24D0682149 · Waiver
280 BARCLAY AVE W, PINE RIVER, MN 56474(218) 587-4416(218) 587-2677 Get Directions Write a Review

NPPES record last updated: February 27, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 24, 2020, Jan 9, 2017 (2 updates tracked since 2017).

About Essentia Health St. Joseph's-pine River Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ESSENTIA HEALTH ST. JOSEPH'S-PINE RIVER CLINIC (NPI 1649223603) is a healthcare organization registered as a primary care in Pine River, Minnesota and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through September 30, 2027, maintains a secondary practice location in Pine River, and lists Kevin Boren, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1649223603
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameST. JOSEPH'S MEDICAL CENTER
Location Address280 BARCLAY AVE WPine River, MN 56474-5197
Mailing Address280 Barclay Ave WPine River, MN 56474-5197 · (218) 587-4416 · Fax (218) 587-2677
Fax(218) 587-2677
Organization SubpartYesParent: Essentia Health
Authorized OfficialKevin BorenVp Of Finance · (218) 786-1009
Enumeration DateMay 18, 2006
Last NPPES UpdateFebruary 27, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2024
✔ NPI 1649223603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MN · 330736
280 BARCLAY AVE W, Pine River, MN 56474

Other Names 1

Doing Business AsEssentia Health St. Joseph's-pine River Clinic

Secondary Practice Location 1

Location 1415 Barclay AvePine River, MN 56474-5139 · Phone (218) 587-4416 · Fax (218) 587-2677

Other Identifiers 1

Medicaid699019300MN

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. Joseph's-pine River Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

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.

StateEnrollment IDDue date
StateMinnesotaEnrollment IDO20031119000468Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

340

Medicare enrollment records show 340 clinicians reassign Medicare billing to Essentia Health St. Joseph's-Pine River Clinic, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 37

Nurse Practitioner74
Emergency Medicine29
Certified Registered Nurse Anesthetist (CRNA)27
Family Practice27
Neurology18
Hospitalist17
Urology15
Internal Medicine13
29 other specialties120

Nearest to this location (20)

See all 340
Family Practice
NPI 1467670216
415 BARCLAY AVE
Pine River, MN 56474
(218) 587-4416
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1720649346
415 BARCLAY AVE
Pine River, MN 56474
(218) 587-4416
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1023626918
415 BARCLAY AVE
Pine River, MN 56474
(218) 587-4416
✔ PECOS✔ Accepts Medicare0.4 mi
Family Practice
NPI 1710961776
4317 W WOODMAN ST
Pequot Lakes, MN 56472
(218) 568-4416
✔ PECOS✔ Accepts Medicare9.2 mi
Nurse Practitioner
NPI 1487095915
4317 W WOODMAN ST
Pequot Lakes, MN 56472
(218) 568-4416
✔ PECOS✔ Accepts Medicare9.2 mi
Family Practice
NPI 1962464230
35205 COUNTY ROAD 3
Crosslake, MN 56442
(218) 692-1010
✔ PECOS✔ Accepts Medicare14 mi
Nurse Practitioner
NPI 1659621977
35205 COUNTY ROAD 3
Crosslake, MN 56442
(218) 692-1010
✔ PECOS✔ Accepts Medicare14 mi
Nurse Practitioner
NPI 1033844121
20918 COUNTY ROAD 1
Emily, MN 56447
(218) 763-4800
✔ PECOS✔ Accepts Medicare21 mi
Nurse Practitioner
NPI 1700112547
20918 COUNTY ROAD 1
Emily, MN 56447
(218) 763-4800
✔ PECOS✔ Accepts Medicare21 mi
Cardiovascular Disease (Cardiology)
NPI 1326669235
523 N 3RD ST ESSENTIA HEALTH
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Anesthesiology
NPI 1114245297
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Internal Medicine
NPI 1831350123
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Emergency Medicine
NPI 1477131340
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1235869942
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Hospitalist
NPI 1780223164
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Psychiatry
NPI 1215461256
523 N 3RD ST FL 4
Brainerd, MN 56401
(218) 828-7394
✔ PECOS✔ Accepts Medicare26 mi
Nurse Practitioner
NPI 1083014385
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Family Practice
NPI 1992771430
523 N 3RD ST
Brainerd, MN 56401
(218) 828-7494
✔ PECOS26 mi
Pathology
NPI 1619945458
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
Hematology
NPI 1285826446
523 N 3RD ST
Brainerd, MN 56401
(218) 829-2861
✔ PECOS✔ Accepts Medicare26 mi
See all 340 clinicians

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 Waiver 24D0682149

Essentia Health St Josephs - Pine River Clinic · Pine River, MN
Active · expires Sep 30, 2027
CLIA Number24D0682149
Laboratory TypeCommunity Clinic
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorDanielle L. Ashcroft
Laboratory Phone(218) 587-4416
Laboratory LocationEssentia Health St Josephs - Pine River Clinic280 Barclay Ave W, Pine River, MN 56474
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently 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. Joseph's Medical Center's NPI number?

The NPI number for St. Joseph's Medical Center is 1649223603. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Essentia Health St. Joseph's-Pine River Clinic.

Where is St. Joseph's Medical Center located?

St. Joseph's Medical Center is located at 280 Barclay Ave W, Pine River, MN 56474. The listed phone number is (218) 587-4416.

What is St. Joseph's Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is St. Joseph's Medical Center enrolled in Medicare?

Yes. St. Joseph's Medical Center is registered in the Medicare PECOS enrollment system.

When is St. Joseph's Medical 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 December 31, 2026. 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. Joseph's Medical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 340 clinicians in 37 Medicare specialties reassign their Medicare billing to St. Joseph's Medical 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 (74), Emergency Medicine (29) and Certified Registered Nurse Anesthetist (CRNA) (27). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does St. Joseph's Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0682149) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St. Joseph's Medical Center accept?

Health plans from Sanford Health Plan list St. Joseph's Medical 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. Joseph's Medical Center was last updated on February 27, 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.