NPIMap

Fairview Health Services

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Minneapolis, MN

NPI 1407833643 · NPPES record last updated Jul 9, 2026

Key facts

NPI
1407833643
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
02098 (MN)
Legal business name
FAIRVIEW HEALTH SERVICES
Practice address
2450 Riverside Ave Unit C2300
Minneapolis, MN 55454-1450
Phone
(612) 365-2300
Fax
(612) 365-2301
NPI assigned
Dec 29, 2005
Organization subpart
No

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Corporate family (same tax ID) 24

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Capitol Park Mental Health Hospital
Saint Paul, MN · CCN 244019		 Hospital 5% Or Greater Direct Ownership Interest (12.1%) Dec 7, 2021
Accentcare Fairview Home Health - East, LLC
Oakdale, MN · CCN 247166		 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Home Health - West, LLC
Saint Paul, MN · CCN 247078		 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Hospice - West, LLC
Saint Paul, MN · CCN 241514		 Hospice 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050811001092 MN Part a Provider - End-Stage Renal Disease Facility (ESRD) 1951213057 Practice locations: Minneapolis, MN

National Provider Directory

Tax ID family
Mesaba Clinic (69 organizations share this tax ID)

Locations

2450 Riverside Ave
Unit C2300
Minneapolis, MN 55454

2450 Riverside Ave
Ste C230
Minneapolis, MN 55454

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 02098 MN Yes

Addresses

Primary practice location

2450 Riverside Ave Unit C2300
Minneapolis, MN 55454-1450

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other identifiers

IdentifierTypeStateIssuer
1006055OtherMNPREFERREDONE
1012HRIOtherMNBCBS
2OtherMNHEALTHPARTNERS
300050OtherMNUCARE
5000803OtherMNMEDICA
616845106MedicaidMN

Other names

  • Fairview Hospital University Kidney Center Doing business as
  • University of MN Medical Center, Fairview Renal Dialysis Center Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2026.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1407833643",
    "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 UNIT C2300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-365-2300",
            "fax_number": "612-365-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "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": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MN",
            "license": "02098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1006055",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1012HRI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "2",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "300050",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5000803",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616845106",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Hospital University Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of MN Medical Center, Fairview Renal Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of MN Medical Center, Fairview Renal Dialysis Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.