NPIMap

Organization Active NPI

Allina Health System

Doing business as Allina Health Specialty Clinic River Falls

  • Clinic/Center
  • River Falls, WI
National Provider Identifier
1619559663
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ALLINA HEALTH SYSTEM
Doing business as
Allina Health Specialty Clinic River Falls
Practice address
1687 E Division St
River Falls, WI 54022-1571
Phone
(715) 307-6405
NPI assigned
Apr 28, 2021
Last updated
Feb 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1687 E Division St
River Falls, WI 54022-1571

Mailing address

PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other names 1

  • Allina Health Specialty Clinic River Falls Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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 WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000417 WI Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 522 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baldwin, WI; River Falls, WI; Grantsburg, WI; Prescott, WI
O20221214000269 WI Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 308 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: River Falls, WI

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Locations

1617 E Division St
River Falls, WI 54022
Phone (715) 307-6600

Practitioners & affiliated clinicians

Practitioners 130

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.

View all 130

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1619559663",
    "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": "1687 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "715-307-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "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": 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": "Allina Health Specialty Clinic River Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.

Verify at the official NPI Registry.