NPIMap

Organization Active NPI

Altru Health System

Doing business as Altru Health System-Renal Dialysis at Lifecare

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Roseau, MN
National Provider Identifier
1144518549
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ALTRU HEALTH SYSTEM
Doing business as
Altru Health System-Renal Dialysis at Lifecare
Practice address
711 Delmore Dr
Roseau, MN 56751-1534
Phone
(701) 780-5877
Fax
(701) 780-5852
NPI assigned
Jul 19, 2011
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ALTRU HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Derek Goebel
Title
Chief Financial Officer
Phone
(701) 780-1470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NU Primary

Addresses

Primary practice location

711 Delmore Dr
Roseau, MN 56751-1534

Mailing address

PO Box 860939
Minneapolis, MN 55486-0939

Other names 1

  • Altru Health System-Renal Dialysis at Lifecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120210000577 MN Part A Provider - End-Stage Renal Disease Facility (ESRD) 1355251604 1 other NPI on this enrollment
Practice locations: Roseau, MN

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Altru Health System Renal Dialysis at LifecareCCN 243540
Overall star rating
5.0 of 5
Ownership
Non-profit
Certified
Dec 19, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
6

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Physicians Associates M24 organizations share this tax ID, including this one
Part of
Physicians Associates M

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Altru Rehabilitation HospitalGrand Forks, ND, CCN 353027 Hospital 5% Or Greater Direct Ownership Interest (40%) May 24, 2021
Valley Senior Living on ColumbiaGrand Forks, ND, CCN 355067 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 1994
May 21, 2025
Woodside VillageGrand Forks, ND, CCN 355112 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 1994
May 21, 2025
Altru's Home HealthGrand Forks, ND, CCN 357014 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1997

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

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": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1144518549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860939",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "701-780-5877",
            "fax_number": "701-780-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTRU HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALTRU HEALTH SYSTEM",
        "enumeration_date": "2011-07-19",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "GOEBEL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "701-780-1470"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altru Health System-Renal Dialysis at Lifecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Altru Health System-Renal Dialysis at Lifecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseau, MN

Sources for this page

Verify at the official NPI Registry.