NPIMap

Organization Active NPI

Family Healthservices Minnesota, P.a.

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1629258355
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1428 Issued in MN
Legal business name
FAMILY HEALTHSERVICES MINNESOTA, P.A.
Practice address
1050 Larpenteur Ave W
Saint Paul, MN 55113-6556
Phone
(651) 788-4444
Fax
(651) 487-1705
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Ken Palattao
Title
Cao
Phone
(651) 772-1572

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1428 MN Primary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X

Addresses

Primary practice location

1050 Larpenteur Ave W
Saint Paul, MN 55113-6556

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Other names 1

  • Entira Family Clinics-Como/Roseville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071215000036 MN Part B Supplier - Clinic/Group Practice 1355369018 Receives reassigned benefits from 60 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Paul, MN; Woodbury, MN; West St Paul, MN; Vadnais Heights, MN; Shoreview, MN; Hugo, MN; North St Paul, MN

Other NPIs on the same Medicare enrollment 8

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0667499Entira Family Clinics Como/Roseville1050 W Larpenteur Avenue, Saint Paul, MN 55113AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Entira Family Clinics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1629258355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LARPENTEUR AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136556",
            "telephone_number": "651-788-4444",
            "fax_number": "651-487-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHSERVICES MINNESOTA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "PALATTAO",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "651-772-1572"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "1428",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Entira Family Clinics-Como/Roseville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Entira Family Clinics-Como/Roseville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.