Avera Medical Group Granite Falls | |
345 10th Ave Granite Falls MN 56241-1442 | |
(320) 564-3111 | |
Not Available |
Full Name | Avera Medical Group Granite Falls |
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Speciality | Family Medicine |
Location | 345 10th Ave, Granite Falls, Minnesota |
Authorized Official Name and Position | Debra Streier (PRESIDENT/CEO) |
Authorized Official Contact | 5075379160 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Avera Medical Group Granite Falls 300 S Bruce St Marshall MN 56258-1934 Ph: () - | Avera Medical Group Granite Falls 345 10th Ave Granite Falls MN 56241-1442 Ph: (320) 564-3111 |
NPI Number | 1700429644 |
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Provider Enumeration Date | 10/23/2019 |
Last Update Date | 06/30/2021 |
Medicare PECOS PAC ID | 1456784560 |
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Medicare Enrollment ID | O20200106000646 |
Identifier | Type | State | Issuer |
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1700429644 | NPI | - | NPPES |
Provider Name | Martin H Janning |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1396963922 PECOS PAC ID: 0749194991 Enrollment ID: I20031113000156 |
Provider Name | Eleazar P Briones |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1255338067 PECOS PAC ID: 7315843869 Enrollment ID: I20031208000476 |
Provider Name | Sabina Choudhry |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1447212899 PECOS PAC ID: 5698678167 Enrollment ID: I20040203000977 |
Provider Name | Daryl C. Rife |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1326000811 PECOS PAC ID: 0143123612 Enrollment ID: I20040203001059 |
Provider Name | Patrick A Nelson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1518929892 PECOS PAC ID: 2860395340 Enrollment ID: I20040315001034 |
Provider Name | Kenneth Hoj |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1053352567 PECOS PAC ID: 5991762239 Enrollment ID: I20041217000501 |
Provider Name | Kevin W Peterson |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1912971581 PECOS PAC ID: 7719954270 Enrollment ID: I20050112000041 |
Provider Name | Christie Ann Van Hecke |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215996244 PECOS PAC ID: 3476441551 Enrollment ID: I20050712000424 |
Provider Name | Jerome T Durfee |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1104016153 PECOS PAC ID: 4183648819 Enrollment ID: I20060420000246 |
Provider Name | Thomas Joseph Chapa |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1710933502 PECOS PAC ID: 1355354507 Enrollment ID: I20060711000283 |
Provider Name | Curtis Ronald Louwagie |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1689688897 PECOS PAC ID: 6901809938 Enrollment ID: I20060814000068 |
Provider Name | Noah N Chelliah |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1952485740 PECOS PAC ID: 9032166038 Enrollment ID: I20061205000606 |
Provider Name | Daniel F Florey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629035365 PECOS PAC ID: 0345240537 Enrollment ID: I20070112000076 |
Provider Name | Denay Kelly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376505131 PECOS PAC ID: 7113998774 Enrollment ID: I20070515000497 |
Provider Name | Christopher Gregory |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1821050212 PECOS PAC ID: 3971498544 Enrollment ID: I20071106000268 |
Provider Name | Sandra K Hanson |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1750367512 PECOS PAC ID: 2466501820 Enrollment ID: I20090514000520 |
Provider Name | Steven L Kidd |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1700852589 PECOS PAC ID: 3577604396 Enrollment ID: I20091230000515 |
Provider Name | Steven R Bell |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1417923723 PECOS PAC ID: 7113823964 Enrollment ID: I20100111000832 |
Provider Name | Arthur J Rillo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619943404 PECOS PAC ID: 9234271677 Enrollment ID: I20100122000209 |
Provider Name | Darrell L Carter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013976794 PECOS PAC ID: 8729122858 Enrollment ID: I20100212000472 |
Provider Name | Brad Alan Paulson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1750343232 PECOS PAC ID: 4587656129 Enrollment ID: I20100818000189 |
Provider Name | Ryan David Jepperson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1184836199 PECOS PAC ID: 5799800470 Enrollment ID: I20101109001568 |
Provider Name | Andrew I Soye |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1790747905 PECOS PAC ID: 4880597350 Enrollment ID: I20110222001138 |
Provider Name | Enrico Jl Ocampo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1174501159 PECOS PAC ID: 3870533359 Enrollment ID: I20111129000362 |
Provider Name | Matthew S Helgeson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1568429397 PECOS PAC ID: 8729072699 Enrollment ID: I20120405000164 |
Provider Name | Thomas G Lewison |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1790034742 PECOS PAC ID: 3779733928 Enrollment ID: I20121024000110 |
Provider Name | Timothy K Joyce |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447696687 PECOS PAC ID: 0042450918 Enrollment ID: I20130717000670 |
Provider Name | Kevin K Casper |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1609213453 PECOS PAC ID: 1254573496 Enrollment ID: I20130816000755 |
Provider Name | Vikram Chatrath |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1205264074 PECOS PAC ID: 1254567449 Enrollment ID: I20131118000767 |
Provider Name | Matthew R Casey |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1740227933 PECOS PAC ID: 4385656149 Enrollment ID: I20140324001233 |
Provider Name | Suzanne L Woodward |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1437275138 PECOS PAC ID: 8224220157 Enrollment ID: I20140324001653 |
Provider Name | Daniel L Crosby |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1619939139 PECOS PAC ID: 1658565205 Enrollment ID: I20140324001976 |
Provider Name | Joseph J Baka |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1538121017 PECOS PAC ID: 3274726625 Enrollment ID: I20140325001611 |
Provider Name | Ganesh Asaithambi |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1588807143 PECOS PAC ID: 5698918852 Enrollment ID: I20140717000325 |
Provider Name | Jesse James Corry |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1215964499 PECOS PAC ID: 3577568823 Enrollment ID: I20140729000823 |
Provider Name | Katherine Esse |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1720255367 PECOS PAC ID: 9537385471 Enrollment ID: I20140729001934 |
Provider Name | Ajay B Shalwala |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1770711889 PECOS PAC ID: 9032359989 Enrollment ID: I20140804000193 |
Provider Name | Joann Lorraine Steinbach |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659799609 PECOS PAC ID: 6406174887 Enrollment ID: I20150415000804 |
Provider Name | Jennifer L Hillestad |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407234982 PECOS PAC ID: 9133430762 Enrollment ID: I20150623001302 |
Provider Name | Tracy Huntington |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1225297724 PECOS PAC ID: 8426121781 Enrollment ID: I20150713002283 |
Provider Name | Troy C Bruns |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699141929 PECOS PAC ID: 4981911013 Enrollment ID: I20150922000924 |
Provider Name | Megan J Hora |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1942590419 PECOS PAC ID: 9537458021 Enrollment ID: I20160524000350 |
Provider Name | Alain Desy |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1922003409 PECOS PAC ID: 6103712773 Enrollment ID: I20160531002099 |
Provider Name | Kevin J Mahoney |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1912344151 PECOS PAC ID: 6406147073 Enrollment ID: I20160629001157 |
Provider Name | Maggie J Limoges |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1104119965 PECOS PAC ID: 1850683517 Enrollment ID: I20160718000191 |
Provider Name | Wangcai Gao |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1710253752 PECOS PAC ID: 5991000820 Enrollment ID: I20160824002278 |
Provider Name | Lauren A O'brien |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1447513379 PECOS PAC ID: 5799931143 Enrollment ID: I20160919001962 |
Provider Name | Tamala J Schmitz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154870640 PECOS PAC ID: 2163700139 Enrollment ID: I20161025003115 |
Provider Name | Amanda K Enestvedt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609323484 PECOS PAC ID: 5698053106 Enrollment ID: I20161102002767 |
Provider Name | Keyurkumar Shah |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1508919804 PECOS PAC ID: 7911989793 Enrollment ID: I20170105000452 |
Provider Name | Nathan Ho-tai Sit |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1619236098 PECOS PAC ID: 1557666401 Enrollment ID: I20170608002269 |
Provider Name | Kevin J Turneau |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1427032572 PECOS PAC ID: 9032161609 Enrollment ID: I20170619001228 |
Provider Name | Tapan C Thacker |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1376818757 PECOS PAC ID: 8022242650 Enrollment ID: I20170628001426 |
Provider Name | Jane M Vansickle |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1992852602 PECOS PAC ID: 7416220884 Enrollment ID: I20170906002970 |
Provider Name | Daniel T Offerdahl |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1467968925 PECOS PAC ID: 1355604083 Enrollment ID: I20180411001927 |
Provider Name | Kasey A Myers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770062804 PECOS PAC ID: 9234489980 Enrollment ID: I20180830001574 |
Provider Name | Anders S Grinde |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1558627760 PECOS PAC ID: 3870895295 Enrollment ID: I20180926002010 |
Provider Name | Tina Y King |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1619413226 PECOS PAC ID: 2769735265 Enrollment ID: I20181031000698 |
Provider Name | Sarah Myers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043785199 PECOS PAC ID: 2668726456 Enrollment ID: I20181114001061 |
Provider Name | Matthew R Frank |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1568874758 PECOS PAC ID: 4880973221 Enrollment ID: I20190708000124 |
Provider Name | Matthew T Pardy |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1306808720 PECOS PAC ID: 9335109446 Enrollment ID: I20190812003287 |
Provider Name | Megan E Flemming |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326673427 PECOS PAC ID: 0345679361 Enrollment ID: I20200326001485 |
Provider Name | Ali Emami |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1275792293 PECOS PAC ID: 3072760230 Enrollment ID: I20200512000593 |
Provider Name | Sherrie Marie Brooks |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1720060858 PECOS PAC ID: 1355247362 Enrollment ID: I20200521000111 |
Provider Name | Reyanna G Massaquoi |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1417330531 PECOS PAC ID: 8921300468 Enrollment ID: I20200702001668 |
Provider Name | Rosa E Rios Avendano |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1720514672 PECOS PAC ID: 6608136908 Enrollment ID: I20200727000092 |
Provider Name | Angela F Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811521446 PECOS PAC ID: 8022434158 Enrollment ID: I20200819002077 |
Provider Name | Anna R F Gregoire |
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Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1700231891 PECOS PAC ID: 9739432170 Enrollment ID: I20200831002994 |
Provider Name | Megan E Albertson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1013334911 PECOS PAC ID: 0143447771 Enrollment ID: I20201007001879 |
Provider Name | Daniel L Sova |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1528370590 PECOS PAC ID: 9234376344 Enrollment ID: I20210521000814 |
Provider Name | Jennifer Ann Monson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083208904 PECOS PAC ID: 7416345970 Enrollment ID: I20211102002949 |
Provider Name | Kristen A Altermatt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194483156 PECOS PAC ID: 9830581784 Enrollment ID: I20220126001896 |
Provider Name | Amber Malikowski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619563954 PECOS PAC ID: 6103211792 Enrollment ID: I20220317001177 |
Provider Name | Emmy Ho |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1700894474 PECOS PAC ID: 5395706691 Enrollment ID: I20220510002672 |
Provider Name | David F Manke |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1992123582 PECOS PAC ID: 4880812916 Enrollment ID: I20220519000481 |
Provider Name | Wade Sendelbach |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033548854 PECOS PAC ID: 1355676909 Enrollment ID: I20220621001545 |
Provider Name | Kassandra Elizabeth Anderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619626652 PECOS PAC ID: 7214318708 Enrollment ID: I20220714002443 |
Provider Name | Nicole Elizabeth Falls |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1841727443 PECOS PAC ID: 9830469774 Enrollment ID: I20220802000352 |
Provider Name | Sandra Kay Turbes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114676178 PECOS PAC ID: 8921481631 Enrollment ID: I20220812001956 |