NPIMap

Organization Active NPI

Marciana Group

Doing business as Mendota Health

  • Medical Specialty Clinic/Center
  • Lakeville, MN
National Provider Identifier
1134719693
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
MARCIANA GROUP
Doing business as
Mendota Health
Practice address
16759 Diamonte Path
Lakeville, MN 55044-6154
Phone
(651) 398-4968
NPI assigned
Jan 19, 2021
Last updated
Sep 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Kimberly Miller
Title
Director of RCM
Phone
(248) 331-7908

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary
Wound Care Registered Nurse 163WW0000X NU

Addresses

Primary practice location

16759 Diamonte Path
Lakeville, MN 55044-6154

Mailing address

PO Box 779348
Chicago, IL 60677-0440
Phone (888) 402-0202

Other practice location 1

1440 W Taylor St Ste 2617
Chicago, IL 60607-4623
Phone (888) 402-0202

Other practice location 2

6101 N Keystone Ave Ste 100
Indianapolis, IN 46220-2499
Phone (888) 402-0202

Other practice location 3

2407 SE Delaware Ave Ste 1044
Ankeny, IA 50021-4470
Phone (888) 402-0202

Other practice location 4

2407 N Callahan St
Wichita, KS 67205-1471
Phone (888) 402-0202

Other practice location 5

3157 Farnam St Ste 7104
Omaha, NE 68131-3553
Phone (888) 402-0202

Other practice location 6

6659 Schaefer Rd Ste 1143
Dearborn, MI 48126-1812
Phone (888) 402-0202

Other practice location 7

1325 N Rankin St
Appleton, WI 54911-3861
Phone (888) 402-0202

Other practice location 8

910 Wolcott St Ste 13
Waterbury, CT 06705-1360
Phone (888) 402-0202

Other names 1

  • Mendota Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, MI, IL, CT, IN, IA, KS, NE, ND, AZ, FL, GA13 enrollments

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
O20210217002750 MN Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 3 practitioners
Practice locations: Mendota Heights, MN
O20210401001908 WI Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 3 practitioners
Practice locations: Appleton, WI
O20210812003101 MI Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI
O20211022002322 IL Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL
O20211124001248 CT Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 3 practitioners
Practice locations: Waterbury, CT
O20211209002417 IN Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Indianapolis, IN
O20220121001686 IA Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Ankeny, IA
O20220314001580 KS Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 5 practitioners
Practice locations: Maize, KS; Wichita, KS
O20220316003381 NE Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE
O20220509002513 ND Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 1 practitioner
Practice locations: Fargo, ND
O20220608000916 AZ Part B Supplier - Clinic/Group Practice 9739594169 Practice locations: Phoenix, AZ
O20241203003857 FL Part B Supplier - Clinic/Group Practice 9739594169 Practice locations: Jacksonville, FL
O20241226001418 GA Part B Supplier - Clinic/Group Practice 9739594169 Receives reassigned benefits from 2 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

2769 W Peoria Ave
Phoenix, AZ 85029

2769 W Peoria Ave
Phoenix, AZ 85029

2769 W Peoria Ave Ste 1169
Phoenix, AZ 85029

1270 Northland Dr
Ste 250
Saint Paul, MN 55120
Phone (833) 642-0391

2136 Ford Pkwy
Ste 5000
Saint Paul, MN 55116

7235 Watson Rd
Saint Louis, MO 63119
Phone (314) 352-5367

7253 Watson Rd
#1298
Saint Louis, MO 63119

1879 Whitehaven Rd
Grand Island, NY 14072

150 E 4th Pl
Ste 204
Sioux Falls, SD 57104

1325 N Rankin St
Appleton, WI 54911

1835 E Edgewood Dr
Appleton, WI 54913
Phone (920) 445-0616

1835 E Edgewood Dr
Ste 105
Appleton, WI 54913
Phone (920) 358-0821

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1134719693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779348",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770440",
            "telephone_number": "888-402-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16759 DIAMONTE PATH",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446154",
            "telephone_number": "651-398-4968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 W Taylor St Ste 2617",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606074623",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6101 N Keystone Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462202499",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2407 SE Delaware Ave Ste 1044",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500214470",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2407 N Callahan St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672051471",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3157 Farnam St Ste 7104",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681313553",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6659 Schaefer Rd Ste 1143",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481261812",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 N Rankin St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113861",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Wolcott St Ste 13",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067051360",
            "country_code": "US",
            "telephone_number": "888-402-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARCIANA GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "248-331-7908"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mendota Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mendota Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.