NPIMap

Organization Active NPI

Fairview Clinics

Doing business as M Health Fairview Clinic Phalen Village

  • Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1124652557
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAIRVIEW CLINICS
Doing business as
M Health Fairview Clinic Phalen Village
Practice address
1414 Maryland Ave E
Saint Paul, MN 55106-2824
Phone
(651) 772-3461
NPI assigned
Feb 25, 2020
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1414 Maryland Ave E
Saint Paul, MN 55106-2824

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other names 1

  • M Health Fairview Clinic Phalen Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000516 MN Part B Supplier - Clinic/Group Practice 7113830142 Receives reassigned benefits from 2,406 practitioners
This NPI is an additional NPI on the enrollment

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
24D0399238Fairview Clinics St Paul Phalen Village Clinic1414 Maryland Ave E, Saint Paul, MN 55106AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Fairview Clinics23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1124652557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MARYLAND AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062824",
            "telephone_number": "651-772-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M Health Fairview Clinic Phalen Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Fairview Clinic Phalen Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.