Active NPI
Allina Health System
Doing business as Minnesota Perinatal Physicians - Mercy
- Maternal & Fetal Medicine Physician
- Coon Rapids, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- Legal business name
- ALLINA HEALTH SYSTEM
- Doing business as
- Minnesota Perinatal Physicians - Mercy
- Practice address
- 3960 Coon Rapids Blvd NW Ste 220
Coon Rapids, MN 55433-2589 - Phone
- (763) 236-8438
- NPI assigned
- Dec 1, 2011
- Last updated
- Feb 24, 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
- Dominica Tallarico
- Title
- Coo
- Phone
- (612) 222-2222
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Maternal & Fetal Medicine Physician | 207VM0101X | Primary |
Addresses
Primary practice location
3960 Coon Rapids Blvd NW Ste 220
Coon Rapids, MN 55433-2589
Mailing address
2925 Chicago Ave
Route 10585
Minneapolis, MN 55407-1321
Phone (612) 262-1166
Other names 1
- Minnesota Perinatal Physicians - Mercy
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service | Other | Ciox Health |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030506000004 | MN | Part A Provider - Hospital | 4587573613 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fridley, MN; Coon Rapids, MN; Cambridge, MN; Buffalo, MN |
| O20040319000460 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 4,246 practitioners This NPI is an additional NPI on the enrollment |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1447527767. Details of each certification follow.
Hospital certification: CCN 240115
- Legal name
- ALLINA HEALTH SYSTEM
- Doing business as
- MERCY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 1, 1970
- Last certification
- Nov 29, 2012
- Beds
- 573 (546 certified)
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- May 1, 1987 (2 total)
- Organization structure
- Corporation
- Enrollment address
- 4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522 - Hospital subgroups
- Acute care
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Allina Health Addiction and Psychotherapy-Mercy Hospital-Unity Campus
- Addiction (Substance Use Disorder) Psychologist
- Fridley, MN
- NPI 1083197214
O20030506000004
-
dba Allina Health Inpatient Addiction Treatment -Mercy Hospital -Unity Campus
- Substance Use Disorder Rehabilitation Hospital Unit
- Fridley, MN
- NPI 1285692145
O20030506000004
-
dba Mercy Hospital
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1316904287
O20030506000004
-
dba Allina Health Mental Health - Mercy Hospital, Unity Campus
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fridley, MN
- NPI 1598700528
O20030506000004
-
dba Mercy Hospital
- Psychiatric Hospital Unit
- Fridley, MN
- NPI 1609056100
O20030506000004
Care Compare: Hospital
Medicare Care Compare- Listed as
- Mercy Hospital
- 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 27
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 |
|---|---|---|---|
| Challis Lowe | Corporate Director | Jun 8, 2022 | |
| John Richard Church | Corporate Director | Sep 9, 2021 | |
| Laura Jean Gillund | Corporate Director | Jun 10, 2015 | |
| Amy L Ronneberg | Corporate Director | Dec 1, 2020 | |
| Daniel Thomas O'Laughlin | Corporate Director | Jan 1, 2022 | |
| Maykao Y Hang | Corporate Director | Jun 13, 2019 | |
| David Allan Joos | Corporate Officer | Oct 1, 2025 | |
| Brian McGrane | Corporate Director | Jun 14, 2024 | |
| Marna Borgstrom | Corporate Director | Jun 13, 2025 | |
| Kelly J Spratt | Corporate Officer | Dec 27, 2025 | |
| Jennifer Soo Alstad | Corporate Director | Jun 10, 2016 | |
| Shari L Ballard | Corporate Director | Jun 10, 2020 | |
| Timothy Aloysius Welsh | Corporate Director | Dec 1, 2017 | |
| Vicki Rasmusen | Corporate Director | Jun 13, 2019 | |
| Debbra Schoneman | Corporate Director | Jun 13, 2013 | |
| James Kolar | Corporate Director | Sep 13, 2024 | |
| Lisa Shannon | Corporate Director | Jan 1, 2022 | |
| Shawn M Ulreich | Corporate Director | Sep 13, 2023 | |
| Chanda L Baker | Corporate Director | Feb 20, 2024 | |
| Melinda Estes | Corporate Director | Jun 13, 2025 | |
| Louis Julius King | Corporate Director | Jun 12, 2017 | |
| Ruth Evelyn Williams-Brinkley | Corporate Director | Sep 13, 2023 | |
| Patricia W Schirmers | Corporate Director | May 6, 2003 | |
| Barbara a Butts Williams | Corporate Director | Jun 10, 2015 | |
| Thomas S Schreier | Corporate Director | Mar 12, 2014 | |
| Dominica Marie Tallarico | Corporate Officer | Mar 11, 2024 | |
| Roger Scott Newcome | Corporate Director | May 6, 2016 | |
| W-2 Managing Employee | May 6, 2016 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1851334825
Corporate Director
Practitioners & affiliated clinicians
Practitioners 30
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.
-
- Internal Medicine Physician
- Minneapolis, MN
- NPI 1770979585
-
- Neonatal Nurse Practitioner
- Coon Rapids, MN
- NPI 1295111300
-
- Clinical Psychologist
- Fridley, MN
- NPI 1710529003
-
- Infectious Disease Physician
- Rochester, MN
- NPI 1154402105
-
- Clinical Child & Adolescent Psychologist
- Minneapolis, MN
- NPI 1306154968
-
- Diagnostic Radiology Physician
- Roseville, MN
- NPI 1861996456
-
- Internal Medicine Physician
- Saint Paul, MN
- NPI 1336439454
-
- Physician Assistant
- Saint Paul, MN
- NPI 1316022684
-
- Medical Physician Assistant
- Minneapolis, MN
- NPI 1417116328
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Coon Rapids, MN
- NPI 1699919290
Interventional Pain Medicine
-
- Women's Health Nurse Practitioner
- Maple Grove, MN
- NPI 1790341865
-
- Mental Health Counselor
- White Bear Lake, MN
- NPI 1124476965
Affiliated clinicians 1,273
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Saint Paul, MN
- NPI 1538692835
Hospital
-
- Cardiovascular Disease Physician
- Coon Rapids, MN
- NPI 1487960357
Hospital
-
- Hospitalist Physician
- Minneapolis, MN
- NPI 1871735936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322697600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740355200000",
"number": "1447527767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"address_2": "ROUTE 10585",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "612-262-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3960 COON RAPIDS BLVD NW STE 220",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332589",
"telephone_number": "763-236-8438"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLINA HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-01",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A",
"authorized_official_last_name": "TALLARICO",
"authorized_official_first_name": "DOMINICA",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "612-222-2222"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.6635.1.1",
"affiliationName": "Ciox Health",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "925 N Point Pkwy",
"city": "Alpharetta",
"state": "GA",
"country_code": "US",
"postal_code": "300055210",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Minnesota Perinatal Physicians - Mercy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Minnesota Perinatal Physicians - Mercy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Coon Rapids, MN
- Allina Health System (Allina Health Coon Rapids Clinic)
- Allina Health System (Core Trauma Service)
- Allina Health System (Mercy Hospital)
- Allina Health System (Metropolitan Heart & Vascular Institute)
- Allina Health System (Allina Health Home Infusion Therapy Services)
- Allina Health System (Hpriverway Hospitalist)
- Allina Health System (Midwest Internal Medicine)
- Allina Health System (Allina Health Mercy General Surgery Clinic)
- Allina Health System (Allina Health Urgent Care Coon Rapids)
- Allina Health System
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.