| Walter Lo Sia Su, MD | |
|
1200 6th Ave N, Centra Care Clinic, St Cloud, MN 56303-2735 | |
| (320) 251-2700 | |
| (320) 240-2118 |
| Full Name | Walter Lo Sia Su |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 36 Years |
| Location | 1200 6th Ave N, St Cloud, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477542371 | NPI | - | NPPES |
| 0407506 | Other | MEDICA HEALTH PLANS | |
| 242513100 | Medicaid | MN | |
| 1013234 | Other | PREFERRED ONE | |
| 242513100 | Other | MEDICAL ASSISTANCE | |
| 379K3S1 | Other | BLUE CROSS BLUE SHIELD | |
| HP21690 | Other | HEALTH PARTNERS | |
| 114449 | Other | UCARE | |
| 526021 | Other | ARAZ GROUP AMERICAS PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 37684 (Minnesota) | Secondary |
| 208M00000X | Hospitalist | 37684 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Centracare - St. Cloud Hospital | Saint cloud, MN | Hospital |
| Centracare- Rice Memorial Hospital | Willmar, MN | Hospital |
| St Gabriels Hospital | Little falls, MN | Hospital |
| Centracare - Monticello Hospital | Monticello, MN | Hospital |
| North Memorial Health - Robbinsdale Hospital | Robbinsdale, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Centracare Clinic | 2466363395 | 800 |
| Entity Name | Centracare Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043212665 PECOS PAC ID: 2466363395 Enrollment ID: O20031105000293 |
| Entity Name | Centracare Health System - Long Prairie |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164471678 PECOS PAC ID: 3870524598 Enrollment ID: O20050823000460 |
| Entity Name | Centracare Health System - Long Prairie |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1164471678 PECOS PAC ID: 3870524598 Enrollment ID: O20061104000579 |
| Entity Name | Centracare Health System-nr LLC |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1275872772 PECOS PAC ID: 3870739410 Enrollment ID: O20130426000215 |
| Entity Name | Centracare Health System-nr LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558600874 PECOS PAC ID: 3870739410 Enrollment ID: O20130515000683 |
| Entity Name | Carris Health - Redwood LLC |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1194206748 PECOS PAC ID: 7911259619 Enrollment ID: O20181029001543 |
| Entity Name | Carris Health - Redwood LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265914048 PECOS PAC ID: 7911259619 Enrollment ID: O20181129001082 |
| Mailing Address | Practice Location Address |
|---|---|
| Walter Lo Sia Su, MD 1200 6th Ave N, Centra Care Clinic, St Cloud, MN 56303-2735 Ph: (320) 251-2700 | Walter Lo Sia Su, MD 1200 6th Ave N, Centra Care Clinic, St Cloud, MN 56303-2735 Ph: (320) 251-2700 |