Fairview Maple Grove Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC

Practice address

14500 99TH Avenue North
Maple Grove, MN 55369

Phone

(763) 898-1424

NPI assigned

Apr 23, 2007

Organization subpart

No

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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Fairview Maple Grove Surgery Center, LLC

  • Anesthesiology Physician
  • Maple Grove, MN
  • NPI 1730068032

  7416058300

  Same PAC ID

Listed as

M Health FairviewCCN 24C0001062

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Fairview Maple Grove Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fairview Maple Grove Surgery Center, LLC

  • Anesthesiology Physician
  • Maple Grove, MN
  • NPI 1730068032
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Fairview Express Care

  • Eyewear Supplier
  • Fridley, MN
  • NPI 1942482740

  Member Of

  NPD member

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.

• Barbara Sue Daniels, M.D.

  • Nephrology Physician
  • Minneapolis, MN
  • NPI 1306874458
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1346468253",
    "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": "14500 99TH AVENUE NORTH",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-898-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "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": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Exman, PSY.D., LP
• Gina Fabiano, LAC
• Fairview Clinics (Fairview Clinics-Bass Lake)
• Fairview Clinics (Fairview Clinics-Maple Grove)
• Fairview Express Care
• Fairview Maple Grove Surgery Center, LLC
• Fairview Pharmacy Services LLC (Fairview Maple Grove Clinic MTM)
• Fairview Pharmacy Services LLC (Fariview Pharmacy Maple Grove)
• Faith Family Recovery Center of Maple Grove
• Family Endodontic Specialists PLC (Metro Dentalcare Specialty Center Maple Grove Endodontics)

• Ambulatory Surgical Clinic/Center in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.