NPIMap

Organization Active NPI

North Memorial Health Care

Doing business as North Memorial Health Rehabilitation Therapy Center

  • Rehabilitation Hospital Unit
  • Robbinsdale, MN
National Provider Identifier
1285657247
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
NORTH MEMORIAL HEALTH CARE
Doing business as
North Memorial Health Rehabilitation Therapy Center
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 581-3440
Fax
(763) 581-3441
NPI assigned
Jul 25, 2006
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MEMORIAL HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Stephanie R Gale
Title
Interim Cfo
Phone
(763) 581-4635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

PO Box 735463
Chicago, IL 60673-5463
Phone (763) 581-3440

Other practice location 1

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-9100

Other names 1

  • North Memorial Health Rehabilitation Therapy Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040122000470 MN Part B Supplier - Clinic/Group Practice 0042123028 Receives reassigned benefits from 675 practitioners
43 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Maple Grove, MN; Golden Valley, MN; Minneapolis, MN; Minnetonka, MN; Monticello, MN; New Hope, MN; Robbinsdale, MN; Stillwater, MN…
O20120316000239 MN Part A Provider - Hospital 0042123028 Practice locations: Robbinsdale, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285657247. Details of each certification follow.

Hospital certification: CCN 24T001

Legal name
NORTH MEMORIAL HEALTH CARE
Organization structure
CorporationNon-profit
Enrollment address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 8

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
North Memorial Medical CenterCCN 24T001 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 1984

National Provider Directory

National Provider Directory
Part of
The Monticello Clinic

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Diane Huston Individual Corporate Director Jan 1, 2019
Ramon Alfredo Pastrano Individual Corporate Director Aug 22, 2024
Kenya McKnight-Ahad Individual Corporate Director May 1, 2025
Charlie Weaver Individual Corporate Director May 1, 2025
Eric Jerome Skalland Individual Corporate Director Aug 22, 2024
Stephanie Renee Gale Individual Corporate OfficerInterim Cfo Dec 2, 2024
Alexa Chellsen Individual W-2 Managing EmployeeManager Rev Cycle System Billing Aug 1, 2020
Laurie Lafontaine Individual Operational/Managerial Control Jul 1, 2016
Nicholas Kozlak Individual Corporate Director May 1, 2025
Cameron Keith Berg Individual Corporate Director Aug 22, 2024
Ted Ferrara Individual Operational/Managerial Control Jul 1, 2016
John Foley Individual W-2 Managing EmployeeManager Payer Strategy and Relation Sep 7, 2022
Andrew J Houlton Individual Corporate Director Feb 18, 2021
Carolyn Ogland Vukich Individual Corporate DirectorCmo Aug 20, 2018
W-2 Managing EmployeeCmo Aug 20, 2018
Reuben Moore Individual Corporate Director Jan 1, 2021
Trevor W Sawallish Individual Corporate OfficerCeo Sep 1, 2023
Robert Mahlon Dahl Individual Corporate Director Jan 1, 2018
Warren Mack Individual Operational/Managerial Control Aug 1, 2013
Allen Kemp Individual Corporate Director Aug 22, 2024
Bruce Christensen Individual Corporate Director Jan 1, 2019

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Maple Grove Hospital CorporationMaple Grove, MN, CCN 240214 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 15, 2022
Apr 15, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1285657247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735463",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735463",
            "telephone_number": "763-581-3440",
            "fax_number": "763-581-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-581-3440",
            "fax_number": "763-581-3441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9875 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694648",
            "country_code": "US",
            "telephone_number": "763-581-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH MEMORIAL HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MEMORIAL HEALTHCARE",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "GALE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "763-581-4635"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Memorial Health Rehabilitation Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Memorial Health Rehabilitation Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.