Centracare Clinic Southwest Llc - Medicare Primary Care in Willmar, MN

Centracare Clinic Southwest Llc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Willmar, Minnesota. The current practice location for Centracare Clinic Southwest Llc is 101 Willmar Ave Sw, Willmar, Minnesota. For appointments, you can reach them via phone at (320) 231-5000. The mailing address for Centracare Clinic Southwest Llc is 1200 6th Ave N, Saint Cloud, Minnesota and phone number is (320) 251-2700.

Centracare Clinic Southwest Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1174106264. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (320) 231-5000.

Contact Information

Centracare Clinic Southwest Llc
101 Willmar Ave Sw
Willmar
MN 56201-3556
(320) 231-5000
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameCentracare Clinic Southwest Llc
SpecialityClinic/Center
Location101 Willmar Ave Sw, Willmar, Minnesota
Authorized Official Name and PositionMichael Blair (CFO)
Authorized Official Contact3202555665
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Centracare Clinic Southwest Llc
1200 6th Ave N
Saint Cloud
MN 56303-2735

Ph: (320) 251-2700
Centracare Clinic Southwest Llc
101 Willmar Ave Sw
Willmar
MN 56201-3556

Ph: (320) 231-5000

NPI Details:

NPI Number1174106264
Provider Enumeration Date05/05/2021
Last Update Date04/18/2022

Medicare PECOS Information:

Medicare PECOS PAC ID8426457946
Medicare Enrollment IDO20210602002802

Medical Identifiers

Medical identifiers for Centracare Clinic Southwest Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1174106264NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Centracare Clinic Southwest Llc acts as a billing entity for following providers:
Provider NameAndrew A Hoffmann
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457374035
PECOS PAC ID: 1658273644
Enrollment ID: I20040121000723
Provider NameThomas Campbell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1285610774
PECOS PAC ID: 2062305246
Enrollment ID: I20040203000239
Provider NameKimberly D Rupp-montpetit
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1114023967
PECOS PAC ID: 3173416021
Enrollment ID: I20040204000683
Provider NameSteven J Kuchta
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1962572974
PECOS PAC ID: 4688568157
Enrollment ID: I20040214000149
Provider NameShannon L Elton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245300250
PECOS PAC ID: 0244125516
Enrollment ID: I20040216001247
Provider NameDouglas M Soderberg
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1215997952
PECOS PAC ID: 1557358066
Enrollment ID: I20040427001347
Provider NameEric J Christensen
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1104996123
PECOS PAC ID: 0547259350
Enrollment ID: I20040507000697
Provider NameTodd R Stoeberl
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1013087030
PECOS PAC ID: 7214926021
Enrollment ID: I20040507000740
Provider NameEric J Peterson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1265436059
PECOS PAC ID: 0244220952
Enrollment ID: I20040514000754
Provider NameJaime Schlomann
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1598955858
PECOS PAC ID: 9133100373
Enrollment ID: I20040525001072
Provider NameShelly M Staska
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1114097136
PECOS PAC ID: 9830179746
Enrollment ID: I20040721001631
Provider NameIna Drown
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1104872324
PECOS PAC ID: 0143290346
Enrollment ID: I20040727000425
Provider NameCraig M Doschadis
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1265423925
PECOS PAC ID: 9830162734
Enrollment ID: I20040818000822
Provider NameSteven P Strinden
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1639108814
PECOS PAC ID: 1456327501
Enrollment ID: I20040913000267
Provider NameJessica A Wentzell
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1447280847
PECOS PAC ID: 7618936477
Enrollment ID: I20041007000135
Provider NameJay E Loeppke
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1669551974
PECOS PAC ID: 4284695586
Enrollment ID: I20041020000775
Provider NameGregory M Macik
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1922004514
PECOS PAC ID: 2769445006
Enrollment ID: I20041108001215
Provider NameAnn Marie M Nelson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1710983473
PECOS PAC ID: 7911951801
Enrollment ID: I20050303000294
Provider NameRachel L Tollefsrud
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1144243833
PECOS PAC ID: 3870548332
Enrollment ID: I20050317000227
Provider NameRwanda D Campbell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1174599641
PECOS PAC ID: 5799713129
Enrollment ID: I20050727001129
Provider NameShawn M Mcgee
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1427023514
PECOS PAC ID: 2567493877
Enrollment ID: I20050826000215
Provider NameMaria J Loerzel
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1053390377
PECOS PAC ID: 5890727341
Enrollment ID: I20050906000293
Provider NameShane P Volk
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1972626703
PECOS PAC ID: 3971518697
Enrollment ID: I20060215000816
Provider NameCraig John Bergh
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1780649715
PECOS PAC ID: 5890705917
Enrollment ID: I20060504000026
Provider NameKurt A Martinson
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1245281302
PECOS PAC ID: 8820066889
Enrollment ID: I20060605000148
Provider NameKristel L Arcilla
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1982618674
PECOS PAC ID: 0941203277
Enrollment ID: I20060807000173
Provider NameAmber O Vick
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1972519213
PECOS PAC ID: 2567465776
Enrollment ID: I20060808000415
Provider NameGrayson J Swalin
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1174548986
PECOS PAC ID: 1951304054
Enrollment ID: I20060810000135
Provider NameDaniel W Schminke
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1770580771
PECOS PAC ID: 3971507229
Enrollment ID: I20060829000538
Provider NameCindy Firkins Smith
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1033185343
PECOS PAC ID: 7810893674
Enrollment ID: I20061017000138
Provider NameAdam K Mooberry
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1134327703
PECOS PAC ID: 8123119930
Enrollment ID: I20070808000706
Provider NameCharles Dean Ulrich
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1790741080
PECOS PAC ID: 6901894914
Enrollment ID: I20070810000296
Provider NameTimothy S Mulder
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1336131747
PECOS PAC ID: 1658463211
Enrollment ID: I20070828000020
Provider NameRaza A Khan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1669584249
PECOS PAC ID: 3173616950
Enrollment ID: I20070910000997
Provider NameSoumathy Prosper
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1629271671
PECOS PAC ID: 0143315630
Enrollment ID: I20070928000070
Provider NameMary M Amon
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518902998
PECOS PAC ID: 3072599513
Enrollment ID: I20071017000083
Provider NameAmanda J Buckingham
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1447446455
PECOS PAC ID: 0345337382
Enrollment ID: I20071107000505
Provider NamePamela J Reinertson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1740460971
PECOS PAC ID: 8123108784
Enrollment ID: I20080108000859
Provider NameRyan C Hebrink
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1003077439
PECOS PAC ID: 8325111727
Enrollment ID: I20080717000735
Provider NameMichael A May
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1619142742
PECOS PAC ID: 2062586977
Enrollment ID: I20080811000107
Provider NameAimee L Tebrake
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1467558197
PECOS PAC ID: 5193884070
Enrollment ID: I20081106000633
Provider NameDebra G Peterson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326000241
PECOS PAC ID: 0840341921
Enrollment ID: I20090701000110
Provider NameKene Gina Ogbogu
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1447424247
PECOS PAC ID: 8123173572
Enrollment ID: I20090908000602
Provider NameJessica R Baitani
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1285800466
PECOS PAC ID: 6507912334
Enrollment ID: I20090921000434
Provider NameNathaniel Reuter
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1457479446
PECOS PAC ID: 8921199373
Enrollment ID: I20090924000337
Provider NameChristina B Ferdinand
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1750445433
PECOS PAC ID: 6901942978
Enrollment ID: I20091005000442
Provider NameDaniel S Fuglestad
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1215903935
PECOS PAC ID: 2163562042
Enrollment ID: I20091228000506
Provider NameMark R Johnston
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1912973058
PECOS PAC ID: 8527109354
Enrollment ID: I20091230000566
Provider NameFrederick W Hund
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1427036573
PECOS PAC ID: 0749378115
Enrollment ID: I20100109000208
Provider NameKendall S Bos
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1427024561
PECOS PAC ID: 2567503725
Enrollment ID: I20100109000292
Provider NameDavid A Newcomer
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1619943438
PECOS PAC ID: 5395833750
Enrollment ID: I20100109000302
Provider NameAlan J Roiseland
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1275553117
PECOS PAC ID: 1254317795
Enrollment ID: I20100111000676
Provider NameAnthony G Amon
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1972526564
PECOS PAC ID: 1355327891
Enrollment ID: I20100111000685
Provider NameThomas H Lange
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1215903000
PECOS PAC ID: 0446391593
Enrollment ID: I20100111000823
Provider NameMichael G Nicklawsky
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1841266152
PECOS PAC ID: 3072654128
Enrollment ID: I20100111000827
Provider NameGabrielle A Vencel Olson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306812185
PECOS PAC ID: 6709927858
Enrollment ID: I20100111000831
Provider NameAlan G Olson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1619943081
PECOS PAC ID: 2769570126
Enrollment ID: I20100208000268
Provider NameGregory G Mccallum
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1689642282
PECOS PAC ID: 8527103514
Enrollment ID: I20100302000375
Provider NameJeffrey Ja Enstad
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104885888
PECOS PAC ID: 8325173461
Enrollment ID: I20100315000926
Provider NameWayne R Jandik
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1174514731
PECOS PAC ID: 1254221971
Enrollment ID: I20100824001262
Provider NameTheodore A Peterson
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1457342628
PECOS PAC ID: 2860382512
Enrollment ID: I20100824001296
Provider NameChad M Kissela
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1912998584
PECOS PAC ID: 6204726946
Enrollment ID: I20100824001305
Provider NameLeslee J Jaeger
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1346286838
PECOS PAC ID: 4082738208
Enrollment ID: I20100825000300
Provider NameJohn W Seifert
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1205802931
PECOS PAC ID: 8022133966
Enrollment ID: I20100915000424
Provider NameAnjali Dahiya
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1275709420
PECOS PAC ID: 2961528856
Enrollment ID: I20100928001714
Provider NameRichard A Wehseler
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1609842335
PECOS PAC ID: 3476745274
Enrollment ID: I20101012001040
Provider NameEric M Hernandez
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1154514487
PECOS PAC ID: 1557553351
Enrollment ID: I20101012001049
Provider NameLaurie Claussen O'leary
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1619286184
PECOS PAC ID: 2961681838
Enrollment ID: I20110124001247
Provider NameJohn P Skretvedt
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356532535
PECOS PAC ID: 4385825413
Enrollment ID: I20110223000422
Provider NameSomendra Vaishnav
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1609043843
PECOS PAC ID: 1658552278
Enrollment ID: I20110301001136
Provider NameScott M Abrams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1265498430
PECOS PAC ID: 5496937807
Enrollment ID: I20110307000552
Provider NameJoyce A Tarbet
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1902836109
PECOS PAC ID: 7517047830
Enrollment ID: I20110406000860
Provider NameLeah M Schammel
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1467644450
PECOS PAC ID: 9133307416
Enrollment ID: I20110711000469
Provider NameNathan D Lee
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1962677518
PECOS PAC ID: 3870761570
Enrollment ID: I20110725000410
Provider NameJenell R Mitteness
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316162886
PECOS PAC ID: 3072786334
Enrollment ID: I20111101000628
Provider NameDiane D Zorn
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1285704296
PECOS PAC ID: 3779740840
Enrollment ID: I20120131000940
Provider NameJulianne A Wurm
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1437213121
PECOS PAC ID: 0941467682
Enrollment ID: I20120207000727
Provider NameLucio R Minces
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1811173271
PECOS PAC ID: 3072791003
Enrollment ID: I20121002000539
Provider NameKari L Mobley
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1437381985
PECOS PAC ID: 9335277177
Enrollment ID: I20121022000195
Provider NameTanya L Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366792319
PECOS PAC ID: 5193976488
Enrollment ID: I20121114000377
Provider NameShannon L Larson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972853208
PECOS PAC ID: 3375795115
Enrollment ID: I20121130000449
Provider NameBrennen Gulden
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1043576275
PECOS PAC ID: 7810132206
Enrollment ID: I20130408000476
Provider NameNadiya Beliveau
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366694341
PECOS PAC ID: 8022283373
Enrollment ID: I20130418000329
Provider NameClaire H Dutton
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1386987378
PECOS PAC ID: 3779720255
Enrollment ID: I20130501000387
Provider NameRyan R Davis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427374123
PECOS PAC ID: 7719150242
Enrollment ID: I20130722000201
Provider NameJayme L Vanbeek
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518246826
PECOS PAC ID: 2062653751
Enrollment ID: I20130723000214
Provider NameJessica Jo Martinez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659710820
PECOS PAC ID: 5799926796
Enrollment ID: I20130801000747
Provider NameKiran K Lingala
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1154636926
PECOS PAC ID: 3476787383
Enrollment ID: I20131009000131
Provider NameDavid M Truscinski
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1083059075
PECOS PAC ID: 1557596236
Enrollment ID: I20131105001514
Provider NameEmily Louise Bakker
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1699102152
PECOS PAC ID: 6204062656
Enrollment ID: I20131113001971
Provider NameKristina A Kase
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1609218833
PECOS PAC ID: 7810123544
Enrollment ID: I20131202000307
Provider NameJames E Malkuch
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1053747667
PECOS PAC ID: 1850529264
Enrollment ID: I20140110000134
Provider NameMichael Y Lee
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1902003825
PECOS PAC ID: 1355572645
Enrollment ID: I20140331001055
Provider NameNoelle E Lee
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790967347
PECOS PAC ID: 4284767930
Enrollment ID: I20140408000145
Provider NameAndrew Peter Windsperger
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1124280425
PECOS PAC ID: 8426297623
Enrollment ID: I20140516001300
Provider NameDexter R Casta
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1194043034
PECOS PAC ID: 2365566205
Enrollment ID: I20140609001817
Provider NameCory Alan Yarke
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1346536885
PECOS PAC ID: 7911123369
Enrollment ID: I20140722000418
Provider NameJacob W Eiler
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1255656997
PECOS PAC ID: 8224261979
Enrollment ID: I20140926000795
Provider NameCharles Snow
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1689745747
PECOS PAC ID: 4284804840
Enrollment ID: I20141015002408
Provider NameKellie Ann Prentice
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245635820
PECOS PAC ID: 1355663659
Enrollment ID: I20141121001801
Provider NameLaamy Tiadjeri
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1861705022
PECOS PAC ID: 0244469005
Enrollment ID: I20150122001436
Provider NameNancy J Rost
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1770555344
PECOS PAC ID: 4183766538
Enrollment ID: I20150603001274
Provider NameLana J Dirksen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316381965
PECOS PAC ID: 9436460565
Enrollment ID: I20150616002506
Provider NameAwani A Deshmukh
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1104181304
PECOS PAC ID: 7315259991
Enrollment ID: I20150710000519
Provider NameBrad John Rohr
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1407196975
PECOS PAC ID: 3779721386
Enrollment ID: I20151022002328
Provider NameRebecca J Konen
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1386949337
PECOS PAC ID: 3870776289
Enrollment ID: I20151026000413
Provider NameJennifer Gene Kingery
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982074332
PECOS PAC ID: 9032429733
Enrollment ID: I20151109002526
Provider NameMark R Martens
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1194921973
PECOS PAC ID: 7315236833
Enrollment ID: I20160523000750
Provider NameNathaniel J Slinkard
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1396037651
PECOS PAC ID: 6305078478
Enrollment ID: I20160616001862
Provider NameKatherine F Reigstad
Provider TypePractitioner - Vascular Surgery
Provider IdentifiersNPI Number: 1386872539
PECOS PAC ID: 8527290261
Enrollment ID: I20160803002188
Provider NameAshley M Hieronimus
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1780959148
PECOS PAC ID: 7517262850
Enrollment ID: I20160916000257
Provider NameKendra C Lund
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1639622335
PECOS PAC ID: 4183911431
Enrollment ID: I20160929002098
Provider NameMichael R Enrico
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1912960006
PECOS PAC ID: 5698709848
Enrollment ID: I20161003002134
Provider NameAlicia Grace Floyd
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1033408505
PECOS PAC ID: 2567680713
Enrollment ID: I20170814001669
Provider NameSamantha Jaimee Ganick
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1447420427
PECOS PAC ID: 2163695735
Enrollment ID: I20170921002773
Provider NameTerri Jo Malecek
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366539363
PECOS PAC ID: 0244395598
Enrollment ID: I20171031001575
Provider NameAmy L Vanhorne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457749426
PECOS PAC ID: 5991022477
Enrollment ID: I20171101000193
Provider NameJonathan Aurelio Silva
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1023303245
PECOS PAC ID: 4486944535
Enrollment ID: I20171130000323
Provider NameAlexandra L Malkuch
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1689186207
PECOS PAC ID: 3476813668
Enrollment ID: I20180208000622
Provider NameStephanie Vogel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720590524
PECOS PAC ID: 1951663350
Enrollment ID: I20180323000377
Provider NameBailey A Dykema
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1942717046
PECOS PAC ID: 2769744069
Enrollment ID: I20180327000473
Provider NameTory Lynn Brouwer
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1760830889
PECOS PAC ID: 0244511830
Enrollment ID: I20180525000148
Provider NameDaniel B Pickett
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1174866644
PECOS PAC ID: 9133475478
Enrollment ID: I20180628003150
Provider NameBrandon L Tucker
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1598142457
PECOS PAC ID: 4183970262
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Provider NameDamon M Campbell
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1518285816
PECOS PAC ID: 3375771744
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Provider NameLee M Haggenjos
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003207416
PECOS PAC ID: 6709144892
Enrollment ID: I20180801002195
Provider NameJacob B Dubay
Provider TypePractitioner - Obstetrics/gynecology
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PECOS PAC ID: 2769758895
Enrollment ID: I20180806002971
Provider NameRyan Michael Finn
Provider TypePractitioner - Emergency Medicine
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PECOS PAC ID: 7810269008
Enrollment ID: I20180806003180
Provider NameAnna L Leitch
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1790270148
PECOS PAC ID: 9931457033
Enrollment ID: I20180807000244
Provider NameJaclyn A Johnson
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1811488430
PECOS PAC ID: 3971851072
Enrollment ID: I20180807000581
Provider NameGabriel A Fierro-fine
Provider TypePractitioner - Anesthesiology
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Provider NameSarah Myers
Provider TypePractitioner - Nurse Practitioner
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Provider NameNayera Rafik Attalla Guirguis
Provider TypePractitioner - Obstetrics/gynecology
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Provider NameNatalie K Mathiowetz
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
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Provider NameGavin J Maurer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1164955621
PECOS PAC ID: 4284976895
Enrollment ID: I20190501001696
Provider NameAdewale O Odofin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1972955375
PECOS PAC ID: 3375876899
Enrollment ID: I20190614000699
Provider NameStephanie J Johanneck
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891355913
PECOS PAC ID: 6507191053
Enrollment ID: I20190705001197
Provider NameSakshi Kaul
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1184044067
PECOS PAC ID: 6305141169
Enrollment ID: I20191002000804
Provider NameMeagan A Hoflock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811526403
PECOS PAC ID: 5294165767
Enrollment ID: I20200423002638
Provider NameWade E Paulson
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1447645916
PECOS PAC ID: 1355656984
Enrollment ID: I20200526000075
Provider NameJustin P Stocks
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1811124837
PECOS PAC ID: 0547446361
Enrollment ID: I20200707001585
Provider NameRobert George Johnson
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1891182341
PECOS PAC ID: 0648584664
Enrollment ID: I20200903000244
Provider NameTyler G Goettl
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1205213881
PECOS PAC ID: 3971809484
Enrollment ID: I20201005000621
Provider NameAnn E Johnson
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1205299385
PECOS PAC ID: 5294026720
Enrollment ID: I20201014003072
Provider NameKhalid M Sonbol
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750796629
PECOS PAC ID: 3476778242
Enrollment ID: I20201020002594
Provider NameTraci J Salveson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1407467749
PECOS PAC ID: 2466862180
Enrollment ID: I20201109003260
Provider NameCrystal L Fleischhacker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356956601
PECOS PAC ID: 5698187185
Enrollment ID: I20201207000657
Provider NameTyler J Brower
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1891399978
PECOS PAC ID: 7214349141
Enrollment ID: I20201216002944
Provider NameAmber Erin Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003459629
PECOS PAC ID: 0244657351
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Provider NameSyed Haris Ali
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1033598214
PECOS PAC ID: 7416283932
Enrollment ID: I20210202000754
Provider NameRichard E Belmont
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1013919968
PECOS PAC ID: 8921182379
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Provider NameSasan Moshirzadeh
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1689023186
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Enrollment ID: I20210521000035
Provider NameNicole J Carbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578138020
PECOS PAC ID: 9234532904
Enrollment ID: I20210720000433
Provider NameKathleen M Wesa
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1114965597
PECOS PAC ID: 1254420318
Enrollment ID: I20210729002102
Provider NameCourtney M Klinkhammer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609371939
PECOS PAC ID: 6608129820
Enrollment ID: I20210806000006
Provider NameShaun M Seaburg
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1467036269
PECOS PAC ID: 6507260957
Enrollment ID: I20210806000220
Provider NameOluwatobi O Falade
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1447813431
PECOS PAC ID: 6800121971
Enrollment ID: I20210813001330
Provider NameGamaliel Jesse Ferrer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912460734
PECOS PAC ID: 1759616865
Enrollment ID: I20210813003033
Provider NameRobert H Krieger
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1912367103
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Enrollment ID: I20210819002716
Provider NameLaurel L Wessman
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1922510163
PECOS PAC ID: 0345585709
Enrollment ID: I20210902002137
Provider NameAnna R Fuglestad
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518463983
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Enrollment ID: I20210914002497
Provider NameLaura B Mcdowell
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1578099107
PECOS PAC ID: 0648540864
Enrollment ID: I20210916001443
Provider NameDennis S Guadarrama
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1619350402
PECOS PAC ID: 2365870607
Enrollment ID: I20210927001879
Provider NameBethany J Wendlandt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134898422
PECOS PAC ID: 4183022742
Enrollment ID: I20211012001787
Provider NameLindsey M Beckman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013686955
PECOS PAC ID: 9830587047
Enrollment ID: I20211020002024
Provider NameSarah H Christianson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477217339
PECOS PAC ID: 4082004403
Enrollment ID: I20211129001702
Provider NameBonnie M Henry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649922402
PECOS PAC ID: 9436544178
Enrollment ID: I20220316003189
Provider NameSeth D Nelson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679193957
PECOS PAC ID: 4486076973
Enrollment ID: I20220718001182
Provider NameCourtney A Bothun
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700515582
PECOS PAC ID: 9931580834
Enrollment ID: I20220725001199
Provider NameAbdikafar M Yusuf
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366935363
PECOS PAC ID: 4385067503
Enrollment ID: I20220818002946
Provider NameKyle E Rudningen
Provider TypePractitioner - Dermatology
Provider IdentifiersNPI Number: 1194248013
PECOS PAC ID: 8628326592
Enrollment ID: I20220819002264
Provider NameWesley J Halseth
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1891227971
PECOS PAC ID: 3678844867
Enrollment ID: I20220921002720
Provider NameSarah Margaret Campbell
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1538789631
PECOS PAC ID: 6709200371
Enrollment ID: I20221010001075
Provider NameDiana F Niblack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275255721
PECOS PAC ID: 7315314887
Enrollment ID: I20221115000085
Provider NameDesmond Jy Wah
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366673568
PECOS PAC ID: 5496901787
Enrollment ID: I20221207002883
Provider NameKristen A Williamson
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1104547793
PECOS PAC ID: 8426427782
Enrollment ID: I20221207002923
Provider NameLaurie Claussen O'leary
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619286184
PECOS PAC ID: 2961681838
Enrollment ID: I20221209001612
Provider NameSarah E Lechner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548977267
PECOS PAC ID: 4981074648
Enrollment ID: I20221221003044
Provider NameCassandra R Jackson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1053998781
PECOS PAC ID: 7517369309
Enrollment ID: I20230103000017
Provider NameMegan Ann Woller
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1801500400
PECOS PAC ID: 1153792205
Enrollment ID: I20230127000781
Provider NameDwijesh S Sheth
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1134758576
PECOS PAC ID: 6901223262
Enrollment ID: I20230209002002
Provider NameRobert Imel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1154850592
PECOS PAC ID: 2062764848
Enrollment ID: I20230527000198
Provider NameRose Erickson
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1154005130
PECOS PAC ID: 4284093790
Enrollment ID: I20230630001929
Provider NameChristopher Odens
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1386321651
PECOS PAC ID: 6800240839
Enrollment ID: I20230926000643
Provider NameSamantha Wetzel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750166500
PECOS PAC ID: 3375991748
Enrollment ID: I20231122003007
Provider NameNicholas Teneyuque
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1790002376
PECOS PAC ID: 4688056682
Enrollment ID: I20231122003013
Provider NameMelissa Christine Bray-iverslie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801660881
PECOS PAC ID: 7012368467
Enrollment ID: I20240110001143
Provider NameEmma Sheforgen
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1184481418
PECOS PAC ID: 8123466729
Enrollment ID: I20240402001481
Provider NameJennifer Schmitz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1295312049
PECOS PAC ID: 7810306735
Enrollment ID: I20240510002529
Provider NameMarc Fernandez
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1972571727
PECOS PAC ID: 9638137839
Enrollment ID: I20240613000805

Reviews and Comments


Clinic/Center in Willmar, MN

West Central Solutions, Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 414 Becker Ave Sw Ste 1a, Willmar, MN 56201
Phone: 612-814-7840    
Community Health Service Inc.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1804 Trott Ave Sw, Willmar, MN 56201
Phone: 320-214-7286    Fax: 320-214-7223
Gillette Children's Healthcare Willmar
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1303 1st St S Ste 1, Willmar, MN 56201
Phone: 651-634-1938    
Carris Health Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 101 Willmar Ave Sw, Willmar, MN 56201
Phone: 320-231-5000    
Pearle Vision Willmar
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 2404 1st St S, Willmar, MN 56201
Phone: 320-235-1235    Fax: 320-235-9241
Miller Chiropractic Office
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1804 Trott Ave Sw, Willmar, MN 56201
Phone: 320-235-0880    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.