NPIMap

Organization Active NPI

Mayo Clinic Hospital-Rochester

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lake City, MN
National Provider Identifier
1487620738
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
324083 Issued in MN
Legal business name
MAYO CLINIC HOSPITAL-ROCHESTER
Practice address
500 W Grant St
Lake City, MN 55041-1143
Phone
(651) 345-3321
Fax
(651) 565-4818
NPI assigned
Feb 27, 2006
Last updated
Aug 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MAYO CLINIC HOSPITAL-ROCHESTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Mr. Dennis Dahlen
Title
Chief Financial Officer
Phone
(507) 538-3389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 324083 MN Primary

Addresses

Primary practice location

500 W Grant St
Lake City, MN 55041-1143

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-1937

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131015000009 MN Part A Provider - End-Stage Renal Disease Facility (ESRD) 2860572575 Practice locations: Lake City, MN

Other NPIs with the same Medicare PAC ID 11

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Mayo Clinic Dialysis - Lake CityCCN 243515
Overall star rating
1.0 of 5
Ownership
Non-profit
Certified
May 20, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Mayo Clinic Dialysis
Dialysis stations
8

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
St Marys Hospital Pharm15 organizations share this tax ID, including this one
Part of
St Marys Hospital Pharm

Other organizations with this tax ID 14

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

View all 14

Member of 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1487620738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-1937",
            "fax_number": "507-284-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W GRANT ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411143",
            "telephone_number": "651-345-3321",
            "fax_number": "651-565-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HOSPITAL-ROCHESTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAYO CLINIC HOSPITAL-ROCHESTER",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-538-3389",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MN",
            "license": "324083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.