Active NPI
Fairview Health Services
Doing business as Fairview Diagnostic Laboratory
- General Acute Care Hospital
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- Legal business name
- FAIRVIEW HEALTH SERVICES
- Doing business as
- Fairview Diagnostic Laboratory
- Practice address
- 2450 Riverside Ave
Outreach Lab Department
Minneapolis, MN 55454-1450 - Phone
- (612) 273-7838
- NPI assigned
- Dec 13, 2006
- Last updated
- Feb 19, 2025
- Organization subpart
- No
NPPES NPI Registry
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Primary | ||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
2450 Riverside Ave
Outreach Lab Department
Minneapolis, MN 55454-1450
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740
Other practice location 1
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (855) 324-7842
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 339R1FA | Other | MN | BCBS |
| 1012HRI | Other | MN | BCBS |
| 131760 | Other | MN | UCARE |
| 1033106 | Other | MN | PREFERREDONE |
| 1913206 | Other | MN | MHP |
| 5000803 | Other | MN | MEDICA |
| 27581 | Other | MN | HEALTHPARTNERS |
| 616845100 | Medicaid | MN |
Other names 1
- Fairview Diagnostic Laboratory
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000461 | MN | Part B Supplier - Clinic/Group Practice | 1951213057 |
Receives reassigned benefits from 4,101 practitioners This NPI is an additional NPI on the enrollment |
| O20050811000949 | MN | Part A Provider - Hospital | 1951213057 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20051010000419 | MN | Part A Provider - Hospital | 1951213057 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chisago City, MN; Wyoming, MN; Rush City, MN; Pine City, MN; North Branch, MN; Lino Lakes, MN; Hugo, MN |
NPI to CCN mapping 2
The Medicare certification numbers (CCNs) connected to NPI 1316008212. Details of each certification follow.
Hospital certification: CCN 240080
- Legal name
- FAIRVIEW HEALTH SERVICES
- Doing business as
- FAIRVIEW HOSPITAL UNIVERSITY
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jan 1, 1973
- Last certification
- Jul 17, 2018
- Beds
- 1,700
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Incorporated
- Dec 20, 1972 in MN
- Enrollment address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Hospital subgroups
- General, Acute care
Hospital certification: CCN 240050B
- Legal name
- FAIRVIEW HEALTH SERVICES
- Doing business as
- FAIRVIEW LAKES HOSPITAL
- Organization structure
- Corporation
- Incorporated
- Dec 20, 1972 in MN
- Enrollment address
- 5200 Fairview Blvd
Wyoming, MN 55092-8013 - Hospital subgroups
- General, Acute care
Related certifications (CCN) 2
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba UMMC, Fairview (Psych Unit)
- Psychiatric Hospital Unit
- Minneapolis, MN
- NPI 1679121024
-
dba Fairview Acute Rehabilitation Center
- Rehabilitation Hospital Unit
- Minneapolis, MN
- NPI 1851378038
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
O20050811000949
-
dba Fairview Lakes Hospital
- General Acute Care Hospital
- Wyoming, MN
- NPI 1083692941
O20051010000419
-
dba Fairview Diagnostic Laboratory
- General Acute Care Hospital
- Wyoming, MN
- NPI 1134280035
O20051010000419
-
dba University of MN Medical Center, Fairview Transitional Care
- Skilled Nursing Facility
- Minneapolis, MN
- NPI 1669459913
O20050811000949
Care Compare: Hospital
Medicare Care Compare- Listed as
- M Health Fairview University of MN Medical Center
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa Ann Geller | Corporate Director | Jan 1, 2022 | |
| David Martin Levy | Corporate Director | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2022 | ||
| Maureen Veronica-Reger Ring | Corporate Director | Dec 1, 2022 | |
| W-2 Managing Employee | Dec 1, 2022 | ||
| Corporate Director | Dec 1, 2022 | ||
| W-2 Managing Employee | Dec 1, 2022 | ||
| Stephen Jeffrey Swensen | Corporate Director | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2022 | ||
| Srijoy Mahapatra | Corporate Director | Oct 1, 2024 | |
| Jodi Richard | Corporate Director | Jan 1, 2019 | |
| Shawntera Monique Hardy | Corporate Director | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2022 | ||
| Joe Charles Gaylord | Corporate Officer | Dec 1, 2022 | |
| Operational/Managerial Control | Dec 1, 2022 | ||
| Corporate Director | Sep 1, 2022 | ||
| Kenneth Joseph Roering | Corporate Director | Feb 23, 2017 | |
| Corporate Director | Feb 23, 2017 | ||
| James Hereford | Corporate Director | Dec 10, 2016 | |
| Paul Jr Hill | Corporate Director | Jan 1, 2022 | |
| Tami Lynn Reller | Corporate Director | May 9, 2024 | |
| Michael Roger Connly | Corporate Director | Jan 1, 2023 | |
| Corporate Director | Jun 1, 2017 | ||
| Karen Swearingen Richard | Corporate Director | Jan 1, 2025 | |
| John Charles Heinmiller | Corporate Director | Jul 1, 2001 | |
| Corporate Director | Jul 1, 2017 | ||
| Julie S Causey | Corporate Director | Jun 1, 2017 | |
| Barclay Edward Berdan | Corporate Director | Jan 1, 2022 | |
| Timothy Engel Marx | Corporate Director | 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.
-
- Gynecologic Oncology Physician
- Minneapolis, MN
- NPI 1265466809
Corporate Director
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.
-
- Physician Assistant
- Saint Paul, MN
- NPI 1699920819
Affiliated clinicians 2,406
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Cardiovascular Disease Physician
- Coon Rapids, MN
- NPI 1487960357
Hospital
-
- Family Medicine Physician
- Blaine, MN
- NPI 1538659198
Hospital
-
- Gerontology Nurse Practitioner
- Minneapolis, MN
- NPI 1396417572
Hospital
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1033503040
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739923200000",
"number": "1316008212",
"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": "2450 RIVERSIDE AVE",
"address_2": "OUTREACH LAB DEPARTMENT",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-273-7838"
}
],
"practiceLocations": [
{
"address_1": "500 Harvard St SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554550363",
"country_code": "US",
"telephone_number": "855-324-7842",
"fax_number": "612-672-6041",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FAIRVIEW HEALTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-13",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"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": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": true
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "339R1FA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1012HRI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "131760",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1033106",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHP",
"identifier": "1913206",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "5000803",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "27581",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "616845100",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Fairview Diagnostic Laboratory",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Minneapolis, MN
- Fairview Express Care
- Fairview Express Care
- Fairview Health Servcies (Fairview Hospital University Pharmacy - East)
- Fairview Health Servcies (Fairview Hospital University Pharmacy - Riverside)
- Fairview Health Services (Fairview Hospital University)
- Fairview Health Services (Fairview Hospital University Kidney Center)
- Fairview Health Services
- Fairview Health Services (Fairview Minneapolis Clinics and Surgery Center)
- Fairview Health Services (University of MN Medical Center, Fairview Transitional Care)
- Fairview Health Services (UMMC, Fairview (Psych Unit))
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.