CENTRACARE CLINIC
NPI 1669994315
Clinic/Center - Primary Care in Saint Cloud, MN
About Centracare Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTRACARE CLINIC (NPI 1669994315), doing business as Centracare - Southway Clinic, is a healthcare organization registered as a primary care in Saint Cloud, Minnesota and active in the NPI registry since July 2017. The organization lists Michael A Blair, Sr Vp & Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Centracare Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 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.
Clinicians Billing Medicare Through This Organization
1,050Medicare enrollment records show 1,050 clinicians reassign Medicare billing to Centracare Clinic, which bills Medicare for the services they deliver. Of these, 18 practice at this address and 645 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 46
Nearest to this location (20)
See all 1,050Saint Cloud, MN 56301
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Centracare Clinic's NPI number?
The NPI number for Centracare Clinic is 1669994315. It was assigned to this organization in the NPPES registry on July 14, 2017. The provider is doing business as CentraCare - Southway Clinic.
Where is Centracare Clinic located?
Centracare Clinic is located at 1301 33rd St S, Saint Cloud, MN 56301. The listed phone number is (320) 251-8181.
What is Centracare Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Centracare Clinic enrolled in Medicare?
Yes. Centracare Clinic is registered in the Medicare PECOS enrollment system.
When is Centracare Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Minnesota, Multi-Specialty - Physician) is due for revalidation by November 30, 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 Centracare Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1,050 clinicians in 46 Medicare specialties reassign their Medicare billing to Centracare Clinic. 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 (199), Family Practice (127) and Certified Registered Nurse Anesthetist (CRNA) (113). Of these, 18 practice at this address and 645 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Centracare Clinic accept?
Health plans from HealthPartners and Sanford Health Plan list Centracare Clinic 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 Centracare Clinic was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days 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.
# Centracare Clinic · NPI 1669994315
Primary Care organization in Saint Cloud, Minnesota. Organization record, active in the CMS NPPES registry since July 14, 2017.
## Identity
- **NPI:** 1669994315 (Entity type: Organization)
- **Enumerated:** July 14, 2017
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Also known as:** CentraCare - Southway Clinic (Doing Business As)
- **Organization subpart:** Yes (part of Centracare Clinic)
- **Authorized official:** Michael Blair, SR VP & CFO
## Practice location
- **Address:** 1301 33RD ST S, Saint Cloud, MN 56301-9668
- **Phone:** (320) 251-8181 · **Fax:** (320) 257-1733
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (DME, Minnesota, Multi-Specialty - Physician) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1,050 clinicians in 46 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (199), Family Practice (127), Certified Registered Nurse Anesthetist (CRNA) (113); 18 practice at this address and 645 within 10 miles; [full list](https://npiprofile.com/npi/1669994315/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 17, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1669994315) · Data from the CMS NPPES public registry.