NPIMap

Organization Active NPI

Allina Health System

Doing business as New Ulm Medical Center

  • Family Medicine Physician
  • New Ulm, MN
National Provider Identifier
1619911658
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLINA HEALTH SYSTEM
Doing business as
New Ulm Medical Center
Practice address
1217 8TH St N
New Ulm, MN 56073-1552
Phone
(507) 217-5011
NPI assigned
Jun 16, 2006
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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X
Clinic/Center 261Q00000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1217 8TH St N
New Ulm, MN 56073-1552

Mailing address

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

Other names 1

  • New Ulm Medical Center 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 MN, CO4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
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
O20061104000144 MN Part A Provider - Critical Access Hospital 4587573613 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winthrop, MN; New Ulm, MN
O20100930037096 MN DME Supplier - Multi-Specialty - Physician 4587573613 Practice locations: New Ulm, MN
O20260219000048 CO Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 1 practitioner
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boulder, CO; Salida, CO; Grand Junction, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619911658. Details of each certification follow.

Hospital certification: CCN 241378

Legal name
ALLINA HEALTH SYSTEM
Doing business as
NEW ULM MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 16, 2005
Last certification
Dec 17, 2008
Beds
62 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1324 5TH St N
New Ulm, MN 56073-1514
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
New Ulm Medical CenterCCN 241378 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

520 Osborne Rd NE
Ste 210
Fridley, MN 55432
Phone (763) 236-3800

1217 8th St N
New Ulm, MN 56073
Phone (507) 217-5000

Ownership & 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.

NameRoleSinceShare
Challis Lowe Individual Corporate Director Jun 8, 2022
John Richard Church Individual Corporate DirectorBoard Member Sep 9, 2021
Laura Jean Gillund Individual Corporate DirectorBoard Member Mar 24, 2021
Amy L Ronneberg Individual Corporate DirectorBoard Member Mar 24, 2021
Daniel Thomas O'Laughlin Individual Corporate Director Jan 1, 2022
Maykao Y Hang Individual Corporate DirectorBoard Member Mar 24, 2021
Carisa Lindmeyer Buegler Individual Corporate OfficerPresident Jan 24, 2026
Brian McGrane Individual Corporate DirectorBoard Member Jun 14, 2024
Marna Borgstrom Individual Corporate DirectorBoard Member Jun 13, 2025
Jennifer Soo Alstad Individual Corporate DirectorBoard Member Mar 24, 2021
Shari L Ballard Individual Corporate DirectorBoard Member Mar 24, 2021
Timothy Aloysius Welsh Individual Corporate DirectorBoard Member Mar 24, 2021
Vicki Rasmusen Individual Corporate DirectorBoard Member May 24, 2021
Debbra Schoneman Individual Corporate DirectorBoard Member Jun 13, 2013
James Kolar Individual Corporate DirectorBoard Member Sep 13, 2024
Lisa Shannon Individual Corporate DirectorPresident and Ceo Jan 1, 2022
Shawn M Ulreich Individual Corporate DirectorBoard Member Sep 13, 2024
Chanda L Baker Individual Corporate DirectorBoard Member Feb 20, 2024
Melinda Estes Individual Corporate DirectorBoard Member Jun 13, 2025
Louis Julius King Individual Corporate DirectorBoard Member Mar 24, 2021
Ruth Evelyn Williams-Brinkley Individual Corporate DirectorBoard Member Sep 13, 2023
Patricia W Schirmers Individual Corporate DirectorDirector Reimbursement May 6, 2003
Barbara a Butts Williams Individual Corporate DirectorBoard Member Mar 24, 2021
Thomas S Schreier Individual Corporate DirectorBoard Member Mar 12, 2014
Dominica Marie Tallarico Individual Corporate OfficerCoo Mar 11, 2024
Roger Scott Newcome Individual Corporate DirectorManager May 6, 2016
W-2 Managing EmployeeManager May 6, 2016
Joshua Steven Shepherd Individual Corporate OfficerVP Oct 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Francis Regional Medical CenterShakopee, MN, CCN 240104 Hospital 5% Or Greater Direct Ownership Interest (47.5%) Nov 15, 2007
Courage Kenny Rehabilitation Institute TRPGolden Valley, MN, CCN 245519 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2013
Jun 1, 2013
Allina Health Restorative SuitesPlymouth, MN, CCN 245624 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 10, 2022

Practitioners & affiliated clinicians

Practitioners 36

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 36

Affiliated clinicians 272

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

View all 272

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1619911658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 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": "1217 8TH ST N",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560731552",
            "telephone_number": "507-217-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "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": "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": "New Ulm Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Ulm Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Ulm, MN

Sources for this page

Verify at the official NPI Registry.