Active NPI
Allina Health System
- Internal Medicine Physician
- St Paul, MN
National Provider Identifier
1508105230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ALLINA HEALTH SYSTEM
- Practice address
- 225 Smith Ave N
Ste 501
St Paul, MN 55102-2545 - Phone
- (651) 726-6200
- Fax
- (651) 726-6201
- NPI assigned
- Jan 31, 2013
- Organization subpart
- No
Practitioners 38
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
| O20221213001713 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 3,000 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryNPPES 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) 262-2222
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Family Medicine) Physician | 207QS1201X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
225 Smith Ave N
Ste 501
St Paul, MN 55102-2545
Mailing address
PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166
Other names 1
- Allina Health United Lung & Sleep Clinic
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service | Other | Ciox Health |
NPI Registry JSON
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740355200000",
"number": "1508105230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"address_2": "MAIL ROUTE 10585",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554400043",
"telephone_number": "612-262-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 SMITH AVE N",
"address_2": "STE 501",
"city": "ST PAUL",
"state": "MN",
"postal_code": "551022545",
"telephone_number": "651-726-6200",
"fax_number": "651-726-6201"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLINA HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-31",
"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": "612-262-2222"
},
"taxonomies": [
{
"code": "207QS1201X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Sleep Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "esmd.cioxhealth.com and OID is '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": "Allina Health United Lung & Sleep Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Allina Health United Lung & Sleep Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Paul, MN
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.