Fairview Health Services
Organization Active NPI Family Medicine Physician · Wyoming, MN
NPI 1417037896 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1417037896
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FAIRVIEW HEALTH SERVICES
- Practice address
- 5200 Fairview Blvd
Wyoming, MN 55092-8013 - Phone
- (651) 982-7000
- Fax
- (651) 982-7110
- NPI assigned
- Oct 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Maureen V Ring
- Title
- Sys Dir Govt Reimb & Netwk Rel
- Phone
- (612) 672-6740
Practitioners 256
-
Asma Adam, MD
-
Sadik Ali, M.D.
-
Allison R Amlie, PA-C
-
Rafael Santiago Andrade, M.D.
-
Michaela Arellano, MPS, LPCC, LADC
-
Kyle Arslanian, MD
-
Kayla Ashton, PA-C, ATC
-
Aybike Bakan-Fischer, PA-C
-
Amy Bandt, CNM
-
Madeline Barnes, MD
-
Amber Alexandra Baumann, PA-C
-
Benjamin Maupin Baumann, PA-C
-
Lucas J Beecher, P.A.
-
Paul L. Benn, M.D.
-
Amit Bhargava, MD
-
Rachel Bialostosky, LICSW
-
Paul Robert Bohjanen, M.D.
-
Jenna L Breidinger, DNP, APRN, CNP
-
Nathan Budde, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Hospitalist Physician |
208M00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
5200 Fairview Blvd
Wyoming, MN 55092-8013
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52191CH | Other | MN | BCBS |
| 806010002 | Medicaid | MN | |
| 136674 | Other | MN | UCARE |
| 108418600 | Medicaid | MN | |
| 806010003 | Medicaid | MN | |
| 51449 | Other | MN | HEALTHPARTNERS |
| 792825401 | Medicaid | MN | |
| 806010000 | Medicaid | MN | |
| FP905 | Other | MN | PREFERREDONE |
| 121112 | Other | MN | UCARE |
| 51329 | Other | MN | HEALTHPARTNERS |
| 806010004 | Medicaid | MN | |
| 73769 | Other | MN | HEALTHPARTNERS |
Other names
- Fairview Lakes Regional Medical Center - Physicians
Other providers in Wyoming, MN
- Fairview Express Care
- Fairview Express Care
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health SVC
- Fairview Pharmacy Services LLC
- Fairview Pharmacy Services LLC
- Fairview Pharmacy Services LLC
All providers in Wyoming, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.