ST CLOUD MN OPHTHALMOLOGY ASC LLC (NPI# 1467499293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467499293 |
| Entity Type | Organization |
| Organization Name | ST CLOUD MN OPHTHALMOLOGY ASC LLC |
| Other Organization Name | ST. CLOUD CENTER FOR OPHTHALMIC SURGERY |
| Practice Address |
2055 15th St N Suite B Saint Cloud MN 56303-1747 |
| Practice Telephone | 3202586620 |
| Practice Fax Number | 3202586622 |
| Mailing Telephone | 3202586620 |
| Mailing Fax Number | 3202586622 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2013-03-13 |
| Authorized Official Name | PHILLIP A CLENDENIN (PRESIDENT) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
331176 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 837620400 | 05 |
| Other Name | Type Code |
|---|---|
| St. Cloud Center for Ophthalmic Surgery | Doing Business As Name - Organization |
| Street Address |
2055 15TH ST N SUITE B |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396733143 | Mitchell Dean Harstad | Optometrist | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-06 |
| 1043650575 | Joel W Nelson | Ophthalmology | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2013-06-28 |
| 1356572804 | Derek John Bonacci | Optometrist | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2009-07-31 |
| 1538157805 | St Cloud Eye Clinic Pa | Ophthalmology | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-11 |
| 1376531079 | Steven William Rice | Ophthalmology | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-07 |
| 1548258221 | Bradley Myren Anderson | Ophthalmology | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-07 |
| 1083602783 | Richard William Lucius | Ophthalmology | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-07 |
| 1427046267 | St Cloud Opticians | Eyewear Supplier (Equipment, not the service) | 2055 15th St N, Saint Cloud, MN 56303-1747 | 2005-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124084843 | St Cloud Outpatient Surgery Ltd | Clinic/Center | 1526 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-04-21 |
| 1669971735 | Manuel R Moran | Clinic/Center | 1526 Northway Dr, Saint Cloud, MN 56303-1255 | 2018-02-05 |
| 1194271239 | Centracare Surgery Center | Clinic/Center | 3701 12th St N, 101, Saint Cloud, MN 56303-2255 | 2016-08-29 |
| 1568858652 | St. Cloud Outpatient Surgery, Ltd. | Clinic/Center | 1526 Northway Dr, Saint Cloud, MN 56303-1255 | 2015-04-15 |
| 1417188830 | St. Cloud Ear, Nose & Throat - Surgical Suites LLC | Clinic/Center | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2009-08-03 |
| 1861538613 | Centracare Surgery Center, LLC | Clinic/Center | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1902410368 | Inspired Spine Surgcenter LLC | Clinic/Center | 7400 France Ave S Ste 102, Edina, MN 55435-4738 | 2020-09-03 |
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1215573209 | Hiawatha Surgery Center LLC | Clinic/Center | 2020 E 28th St Ste 100, Minneapolis, MN 55407-1453 | 2019-11-25 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1942760285 | Altru Health System Ambulatory Surgery Centers LLC | Clinic/Center | 400 S Minnesota St Ste B, Crookston, MN 56716-1808 | 2019-03-22 |
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1891297925 | Pediatric Center Holdings, LLC | Clinic/Center | 15450 Highway 7 Ste 200, Minnetonka, MN 55345-3522 | 2018-03-05 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on ST CLOUD MN OPHTHALMOLOGY ASC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.