CentraCare Clinic - Northway Family Medicine – Multi-Specialty Clinic/Center, NPI 1881696490
Multi-Specialty Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for CentraCare Clinic - Northway Family Medicine
Northway Drive, St. Cloud, Stearns County, Minnesota, 56303, United States
ST CLOUD, MN 56303
Phone: (320) 251-1775
Fax: (320) 240-3131
Type: Mailing
1555 NORTHWAY DR STE 100
SAINT CLOUD, MN 563031258
Phone: (320) 251-1775
Fax: (320) 240-3131
Type: Location
1200 6TH AVE N
SAINT CLOUD, MN 563032736
Phone: (320) 229-4977
Fax: (320) 240-3131
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (314 days ago).
Enrollment records
1
Earliest due date
2025-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930029718 | O | Multi-Specialty - Physician | MN | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56303)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.