Allina Health System

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ALLINA HEALTH SYSTEM

Doing business as

Allina Health Lakeville Specialty Center

Practice address

18465 Orchard TRL
Lakeville, MN 55044-8885

Phone

(952) 428-0950

NPI assigned

Dec 7, 2023

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dominica Tallarico

Title

Coo

Phone

(612) 222-2222

Specialties & licenses 7

Addresses

Other names 1

• Allina Health Lakeville Specialty Center Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Karam, M.D.

  • Vascular Surgery Physician
  • Minneapolis, MN
  • NPI 1942430491
  NPD
• Saieh Khademi, DPM

  • Podiatrist
  • Edina, MN
  • NPI 1033481023
  NPD
• Armine Kocharyan, MD

  • Otology & Neurotology Physician
  • Saint Paul, MN
  • NPI 1629496211
  NPD
• Danielle M Lyons

  • Physician Assistant
  • Apple Valley, MN
  • NPI 1952981664
  NPD
• Aurora Bridget Pautz, CNP

  • Family Nurse Practitioner
  • Savage, MN
  • NPI 1043198591
  NPD
• Nicole Joy Setterlund, PA-C

  • Physician Assistant
  • Minneapolis, MN
  • NPI 1447565890
  NPD
• Maria Kathleen Shue, DO

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1700199049
  NPD
• Maria Jensen Smith

  • Obstetrics & Gynecology Physician
  • Saint Paul, MN
  • NPI 1932780541
  NPD
• Madison Kae Freda Staggert

  • Physician Assistant
  • Faribault, MN
  • NPI 1891494613
  NPD
• Adam M Wennersten, PA-C

  • Physician Assistant
  • Superior, WI
  • NPI 1568619682
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1003683244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43, MAIL ROUTE 10585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18465 ORCHARD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448885",
            "telephone_number": "952-428-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-07",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "TALLARICO",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "612-222-2222"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Coix Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allina Health Lakeville Specialty Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allina Health Lakeville Specialty Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nasra Ali
• Yusuf Mahamed Ali I
• Align Chiropractic PA
• Allina Health Surgery Center - Lakeville
• Allina Health Surgery Center - Lakeville, LLC
• Allina Health System (Allina Health Infusion Center Lakeville)
• Allina Health System (Allina Health Lakeville North Clinic)
• Allina Health System (Allina Health Cancer Institute - Lakeville)
• Allina Health System (Allina Health Lakeville South Clinic)
• Allina Health System (Allina Health Urgent Care - Lakeville)

• Internal Medicine Physician in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.