NPIMap

Organization Active NPI

Catholic Eldercare

  • Skilled Nursing Facility
  • Minneapolis, MN
National Provider Identifier
1124019690
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CATHOLIC ELDERCARE
Practice address
817 Main St NE
Minneapolis, MN 55413-1931
Phone
(612) 379-1370
Fax
(612) 362-2414
NPI assigned
Nov 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Mr. Patrick Zeman
Title
Controller
Phone
(612) 379-1370

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X
Skilled Nursing Facility 314000000X MN Primary

Addresses

Primary practice location

817 Main St NE
Minneapolis, MN 55413-1931

Mailing address

817 Main St NE
Minneapolis, MN 55413-1931
Phone (612) 379-1370

Other identifiers 1

IdentifierTypeStateIssuer
375542800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000604 MN Part A Provider - Skilled Nursing Facility 9537324009 Practice locations: Minneapolis, MN

Skilled nursing facility certification: CCN 245439

Legal name
CATHOLIC ELDERCARE
Doing business as
CATHOLIC ELDERCARE OF MAIN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1987
Last certification
Oct 18, 2024
Beds
164
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1980 in MN
Enrollment address
817 Main St NE
Minneapolis, MN 55413-1900
Nursing home name
CATHOLIC ELDERCARE ON MAIN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Catholic Eldercare on MainCCN 245439
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
164146.8 residents per day on average
Penalties (3 years)
1Fines totaling $24,713

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0401820Catholic Eldercare817 Main St NE, Minneapolis, MN 55413Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John W Mielke Individual Adp of the SNF Feb 6, 2025
Adekola Adetola Individual Adp of the SNF Jan 1, 2024
Marie a Barta Individual Operational/Managerial Control Dec 17, 2019
Adp of the SNF Dec 17, 2019
Gregory T Baumberger Individual Corporate OfficerCeo Jul 17, 2017
Operational/Managerial Control Jul 17, 2017
Trustee of the SNF Jul 17, 2017
Adp of the SNF Jul 17, 2017
Chris R Fitzmorris Individual Managing Control - Governing BodyChair of Finance Committee Jun 1, 2017
Adp of the SNF Jun 1, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1124019690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 MAIN ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131931",
            "telephone_number": "612-379-1370",
            "fax_number": "612-362-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 MAIN ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131931",
            "telephone_number": "612-379-1370",
            "fax_number": "612-362-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC ELDERCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "ZEMAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "612-379-1370",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375542800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.