ESSENTIA HEALTH ST. MARY'S - MAHNOMEN CLINIC
NPI 1750725586
Clinic/Center - Rural Health in Mahnomen, MN

Active since April 23, 2013CLIA 24D2063648 · Waiver
117 N MAIN ST, MAHNOMEN, MN 56557(218) 936-5616 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Essentia Health St. Mary's - Mahnomen Clinic NPPES

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

ESSENTIA HEALTH ST. MARY'S - MAHNOMEN CLINIC (NPI 1750725586) is a healthcare organization registered as a rural health in Mahnomen, Minnesota and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through August 6, 2027 and lists Alan Hurley, Coo, as its authorized official.

NPPES Registry Identity

NPI1750725586
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameST. MARY'S REGIONAL HEALTH CENTER
Location Address117 N MAIN STMahnomen, MN 56557-4003
Mailing Address1027 Washington AveDetroit Lakes, MN 56501-3409 · (218) 847-5611 · Fax (218) 847-0881
Organization SubpartYesParent: Essentia Health
Authorized OfficialAlan HurleyCoo · (701) 364-7667
Enumeration DateApril 23, 2013
Last NPPES UpdateMarch 1, 2024
NPPES CertifiedMarch 1, 2024
✔ NPI 1750725586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
117 N MAIN ST, Mahnomen, MN 56557

Other Names 1

Doing Business AsEssentia Health St. Mary's - Mahnomen Clinic

Other Identifiers 1

Medicaid892442000MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 - Mahnomen 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.

StateEnrollment IDDue date
StateMinnesotaEnrollment IDO20031117000090Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

254

Medicare enrollment records show 254 clinicians reassign Medicare billing to Essentia Health St. Mary's - Mahnomen Clinic, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 39

Nurse Practitioner91
Hospitalist19
Family Practice17
Emergency Medicine14
Obstetrics/Gynecology12
Certified Registered Nurse Anesthetist (CRNA)11
General Surgery10
Internal Medicine9
31 other specialties71

Nearest to this location (20)

See all 254
Nurse Practitioner
NPI 1013483692
410 4TH ST SW
Mahnomen, MN 56557
(218) 835-2514
✔ PECOS✔ Accepts Medicare0.4 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1801287875
900 HILLIGOSS BLVD SE
Fosston, MN 56542
(218) 435-1133
✔ PECOS✔ Accepts Medicare21 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1427122811
900 HILLIGOSS BOULEVARD SE ESSENTIA HEALTH FOSSTON
Fosston, MN 56542
(218) 435-1133
✔ PECOS21 mi
Registered Dietitian or Nutrition Professional
NPI 1841967213
900 HILLIGOSS BLVD SE
Fosston, MN 56542
(218) 435-1133
21 mi
Nurse Practitioner
NPI 1588225239
201 9TH ST W
Ada, MN 56510
(218) 784-5000
✔ PECOS✔ Accepts Medicare26 mi
Family Practice
NPI 1982612099
201 9TH STREET WEST BRIDGES MEDICAL CENTER
Ada, MN 56510
(218) 784-2727
✔ PECOS26 mi
Emergency Medicine
NPI 1124470711
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Obstetrics/Gynecology
NPI 1528009123
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS35 mi
Orthopedic Surgery
NPI 1720123714
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS35 mi
Clinical Social Worker
NPI 1639110265
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1659328375
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Internal Medicine
NPI 1558318428
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Clinical Psychologist
NPI 1407124332
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
General Surgery
NPI 1811965775
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Podiatry
NPI 1205889417
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(188) 475-6112
✔ PECOS✔ Accepts Medicare35 mi
Occupational Therapist in Private Practice
NPI 1578242103
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-0883
35 mi
Diagnostic Radiology
NPI 1831352947
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Psychiatry
NPI 1386687408
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Hospitalist
NPI 1295268993
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ PECOS✔ Accepts Medicare35 mi
Physical Therapist in Private Practice
NPI 1225965023
1027 WASHINGTON AVE
Detroit Lakes, MN 56501
(218) 847-5611
✔ Accepts Medicare35 mi
See all 254 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 24D2063648

Essentia Health St Mary's - Mahnomen Clinic · Mahnomen, MN
Active · expires Aug 6, 2027
CLIA Number24D2063648
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2025
Certificate Expiration DateAugust 6, 2027
Laboratory DirectorAaron W. Sykes
Laboratory Phone(701) 364-8714
Laboratory LocationEssentia Health St Mary's - Mahnomen Clinic117 North Main Street, Mahnomen, MN 56557
CLIA data matches this NPI record on: Address Name
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. Mary's Regional Health Center's NPI number?

The NPI number for St. Mary's Regional Health Center is 1750725586. It was assigned to this organization in the NPPES registry on April 23, 2013. The provider is doing business as Essentia Health St. Mary's - Mahnomen Clinic.

Where is St. Mary's Regional Health Center located?

St. Mary's Regional Health Center is located at 117 N Main St, Mahnomen, MN 56557. The listed phone number is (218) 936-5616.

What is St. Mary's Regional Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

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). Of these, 1 practice within 10 miles. 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 24D2063648) is associated with this NPI, valid through August 6, 2027. 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.