CROIXDALE
NPI 1295151413
Assisted Living Facility in Bayport, MN

NPI Status: Active since March 12, 2014

Contact Information

750 HIGHWAY 95 N
BAYPORT, MN
ZIP 55003
Phone: (651) 275-4800

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 24D2032750
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 11-14-2025

About CROIXDALE

This page provides the complete NPI Profile along with additional information for Croixdale, a provider established in Bayport, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1295151413 assigned on March 2014. The practitioner's primary taxonomy code is 310400000X with license number 358748 (MN). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Mark Meyer (Cfo)

NPI
1295151413
Provider Name
CROIXDALE
Entity Type
Organization
Location Address
750 HIGHWAY 95 N BAYPORT, MN 55003
Location Phone
(651) 275-4800
Mailing Address
750 HIGHWAY 95 N BAYPORT, MN 55003
Mailing Phone
(651) 275-4800
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-12-2014
Last Update Date
03-12-2014
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
358748
License State
MN
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARK MEYER

Authorized Official Title
CFO
Authorized Official Phone
(651) 631-6120

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A708973000OTHER (01)MNUMPI

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2032750
Facility Type
Assisted Living Facility
Certificate Effective Date
November 15, 2023
Certificate Expiration Date
November 14, 2025
Laboratory Director
KELLI SCHWARTZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Croixdale to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for CROIXDALE

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1295151413
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2218525242
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 8 + 5 + 2 + 5 + 2 + 4 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1295151413 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1386333821OPTAGE INC
Organization
Clinic/Center (Rehabilitation)750 HIGHWAY 95 N
BAYPORT, MN 55003
(651) 631-6570

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295151413, enumerated in the NPI registry as an "organization" on March 12, 2014

The provider is located at 750 Highway 95 N Bayport, Mn 55003 and the phone number is (651) 275-4800

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 24D2032750 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on March 12, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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