NPIMap

Organization Active NPI

West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
National Provider Identifier
1336015304
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Practice address
2606 Chicago Ave
Minneapolis, MN 55407-3706
Phone
(651) 602-7500
Fax
(651) 602-7580
NPI assigned
Oct 15, 2025
Organization subpart
Yes
Parent organization
WEST SIDE COMMUNITY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Eric William Hanson
Title
Rev Data & Credentialing Manager
Phone
(651) 389-2560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2606 Chicago Ave
Minneapolis, MN 55407-3706

Mailing address

153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 602-7500

Other practice location 1

624 Smith Ave S
Saint Paul, MN 55107-2620
Phone (651) 602-7500

Other names 1

  • MINNESOTA COMMUNITY CARE MBC - MINNEAPOLIS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000647 MN Part B Supplier - Clinic/Group Practice 2062306434 Receives reassigned benefits from 116 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Paul, MN; Saint Paul Park, MN; Maplewood, MN; St. Paul, MN; Minneapolis, MN

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
WSHC-Homeless Center22 organizations share this tax ID, including this one
Part of
WSHC-Homeless Center

Other organizations with this tax ID 21

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

View all 21

Locations

624 Smith Ave S
Saint Paul, MN 55107
Phone (651) 689-3988

153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1336015304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073706",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Smith Ave S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551072620",
            "country_code": "US",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WEST SIDE COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST SIDE COMMUNITY HEALTH SERVICES, INC.",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "REV DATA & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "651-389-2560"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINNESOTA COMMUNITY CARE MBC - MINNEAPOLIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.