| Centracare - Plaza Clinic (internal Medicine) | |
|
1900 Centracare Circle Centracare Clinic Internal Medicine St Cloud MN 56303 | |
| (320) 229-4928 | |
| Not Available |
| Full Name | Centracare - Plaza Clinic (internal Medicine) |
|---|---|
| Speciality | Clinic/Center |
| Location | 1900 Centracare Circle, St Cloud, Minnesota |
| Authorized Official Name and Position | Michael a Blair (SR VP & CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centracare - Plaza Clinic (internal Medicine) Po Box 735818 Chicago IL 60673-5818 Ph: (320) 229-4977 | Centracare - Plaza Clinic (internal Medicine) 1900 Centracare Circle Centracare Clinic Internal Medicine St Cloud MN 56303 Ph: (320) 229-4928 |
| NPI Number | 1659425114 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 09/17/2026 |
| Certification Date | 09/17/2026 |
| Medicare PECOS PAC ID | 2466363395 |
|---|---|
| Medicare Enrollment ID | O20100930056075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659425114 | NPI | - | NPPES |
| 052720300 | Medicaid | MN | |
| 990228700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | () | Secondary |
Centracare - River Campus Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 Sixth Ave No, Centracare Clinic, St Cloud, MN 56303 Phone: 320-252-5131 Fax: 320-650-1777 |
Centracare Clinic - Lifestyle Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Stockinger Drive, Suite 101, St Cloud, MN 56303 Phone: 320-251-2700 Fax: 320-656-7009 |
Centra Care Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1555 Northway Drive, Suite 200, St Cloud, MN 56303 Phone: 320-240-3157 Fax: 320-240-3143 |
Simplicity Health Direct Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3290 42nd Avenue South, Suite 100, St Cloud, MN 56301 Phone: 320-267-1341 |