Allina Health System
Organization Active NPI Cardiovascular Disease Physician · Minneapolis, MN
NPI 1104050160 · NPPES record last updated Jan 14, 2025
Key facts
- NPI
- 1104050160
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- ALLINA HEALTH SYSTEM
- Practice address
- 800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723 - Phone
- (612) 775-3030
- NPI assigned
- May 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Dominca Tallarico
- Title
- Cfo
- Phone
- (612) 222-2222
Owners & managing parties with NPI records 1
-
Daniel Thomas O'Laughlin, M.D.
Other NPIs on the same Medicare enrollment 22
Related certifications (CCN) 1
Practitioners 34
-
Diana K Benson, MD
-
Jaya Bhattarai, MD
-
Sarah Block, PA-C
-
Amelia Dewit, ACNPC-AG
-
Chelsea Victoria Domeier, PA-C
-
Daniel Quinn Earixson, PH.D., LP
-
Leif Erik Jensen, MD MPH
-
Joseph Karam, M.D.
-
Laura S. Koepp, LMFT
-
Lisa Jo Lippold, MA, LPCC, LADC
-
Katie Jane Lorentz, M.D.
-
Corey L Martin, MD
-
Kevin McElroy, MD
-
Kelly Ann McTeague, M.D.
-
Nicholas Rasmussen, P.A.
-
Timothy J Szopa, DPM
-
Suzanne Natalie Walczak, M.D.
-
Barry M Cabuay, MD
-
Mary Katharine Case, PA-C
Affiliated clinicians 2,935
-
David Aamodt, MD
-
Tor Christian Aasheim, M.D.
-
Mohamad Y Abbas, M.D.
-
Mona Abdel-Bary, MBBCH
-
Raed H Abdelhadi, MD
-
Paul T Abear, MD
-
Matthew G Abeln, M.D.
-
Tess Abrahamson, PA-C
-
Nisha Acharya, M.D.
-
Robyn Elizabeth Achmann, APNP-BC
-
Mary Elizabeth Adam, CNS
-
Dane M Adams, CRNA
-
Haley Marie Adasiewicz, PA-C
-
Benjamin Lee Addicks, M.D.
Medicare Care Compare: Hospital
- Listed as
- Abbott Northwestern Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Hospital certification: CCN 240057
- Legal name
- ALLINA HEALTH SYSTEM
- Doing business as
- ABBOTT NORTHWESTERN HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jan 8, 1970
- Last certification
- Jan 4, 2018
- Beds
- 996 (952 certified)
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 800 E 28TH St
Minneapolis, MN 55407-3723 - Hospital subgroups
- General, Acute care, Other
All disclosed owners & managing parties 26
| Name | Role | Since | Share |
|---|---|---|---|
| Challis Lowe |
Corporate Director |
Jun 8, 2022 | |
| John Richard Church |
Corporate Director |
Sep 9, 2021 | |
| Laura Jean Gillund |
Corporate Director |
Jun 10, 2015 | |
| Amy L Ronneberg |
Corporate Director |
Dec 1, 2020 | |
| Daniel Thomas O'Laughlin |
Corporate Director |
Jan 1, 2022 | |
| Maykao Y Hang |
Corporate Director |
Jun 13, 2019 | |
| David Allan Joos |
Corporate Officer |
Apr 20, 2022 | |
| Brian McGrane |
Corporate Director |
Jun 14, 2024 | |
| Marna Borgstrom |
Corporate Director |
Jun 13, 2025 | |
| Jennifer Soo Alstad |
Corporate Director |
Jun 10, 2016 | |
| Shari L Ballard |
Corporate Director |
Jun 10, 2020 | |
| Timothy Aloysius Welsh |
Corporate Director |
Dec 1, 2017 | |
| Vicki Rasmusen |
Corporate Director |
Jun 13, 2019 | |
| Debbra Schoneman |
Corporate Director |
Jun 13, 2013 | |
| James Kolar |
Corporate Director |
Sep 13, 2024 | |
| Lisa Shannon |
Corporate Director |
Jan 1, 2022 | |
| Shawn M Ulreich |
Corporate Director |
Sep 13, 2023 | |
| Chanda L Baker |
Corporate Director |
Feb 20, 2024 | |
| Melinda Estes |
Corporate Director |
Jun 13, 2025 | |
| Louis Julius King |
Corporate Director |
Jun 12, 2017 | |
| Ruth Evelyn Williams-Brinkley |
Corporate Director |
Sep 13, 2023 | |
| Patricia W Schirmers |
W-2 Managing Employee |
May 5, 2003 | |
| Barbara a Butts Williams |
Corporate Director |
Jun 10, 2015 | |
| Thomas S Schreier |
Corporate Director |
Mar 12, 2014 | |
| Dominica Marie Tallarico |
Corporate Officer |
Mar 11, 2024 | |
| Roger Scott Newcome |
W-2 Managing Employee |
May 6, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030505000007 | MN | Part a Provider - Hospital | 4587573613 |
29 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20040319000460 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 4,246 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
13367 Isle Dr
Baxter, MN 56425
Phone (218) 855-5280
1285 Nininger Rd
Hastings, MN 55033
Phone (651) 480-4200
1210 1st St W
Hastings, MN 55033
Phone (651) 438-1800
2805 Campus Dr
Ste 325
Plymouth, MN 55441
Phone (763) 550-1013
5301 Vernon Ave S
Saint Louis Park, MN 55436
Phone (952) 925-2000
424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Mailing address
PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166
Other names
- Allina Health Minneapolis Heart Institute
Other providers in Minneapolis, MN
- Allina Health System
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- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
All providers in Minneapolis, MN · Cardiovascular Disease Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.