Individual provider Active NPI

Rosa Esmeralda Rios Avendano, M.D.

  • Family Medicine Physician
  • Granite Falls, MN
National Provider Identifier
1720514672
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67090 Issued in MN
Practice address
345 10TH Ave
Granite Falls, MN 56241-1442
Phone
(320) 564-3111
NPI assigned
May 11, 2017
Last updated
Jul 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125070190 IL
Family Medicine Physician 207Q00000X 67090 MN Primary

Addresses

Primary practice location

345 10TH Ave
Granite Falls, MN 56241-1442

Mailing address

1127 N Oakley Blvd
Chicago, IL 60622-3507
Phone (312) 770-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727000092 MN Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 6608136908 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, shared by 13 NPIs, 156 clinicians
Avera Granite FallsGroup PAC ID 1456784560, shared by 4 NPIs, 15 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Worthington, MN 56187-1781
Phone (507) 372-6522

1521 Carlson St
Marshall, MN 56258-2626
Phone (507) 473-4800

345 10TH Ave
Granite Falls, MN 56241-1442
Phone (320) 564-3111

345 10TH Ave
Granite Falls, MN 56241-1499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Tyler CurrentSince Sep 8, 2023 Accepting new patients
Rural Health Care, Inc Family Medicine Current Accepting new patients
Avera Marshall CurrentSince Oct 1, 2022 Accepting new patients
Avera Marshall Current Accepting new patients
Avera Granite Falls Current Accepting new patients
Avera Tyler CurrentSince Sep 8, 2023 Accepting new patients
Avera Marshall CurrentSince Oct 1, 2022 Accepting new patients
Avera Granite Falls Current Accepting new patients
Rural Health Care, Inc CurrentSince Oct 1, 2022 Accepting new patients
Avera Tyler Current Accepting new patients

Locations

345 10th Ave
Granite Falls, MN 56241
Phone (320) 564-3111

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

300 S Bruce St
Ste 100
Marshall, MN 56258

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: rosa.rios.avendano@avera.sdhealthlink.net
  • Direct secure messaging: rriosavendano458139@direct.bmhcc.org

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Avera Granite Falls Health CenterGranite Falls, MN, CCN 241343 Hospital Corporate Director Jul 1, 2023
Avera Granite Falls Health CenterGranite Falls, MN, CCN 24Z343 Hospital Corporate Director Jul 1, 2024
Avera Granite Falls Care CenterGranite Falls, MN, CCN 245243 Skilled nursing facility Managing Control - Governing Body Jul 1, 2023

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1720514672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-770-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 10TH AVE",
            "city": "GRANITE FALLS",
            "state": "MN",
            "postal_code": "562411442",
            "telephone_number": "320-564-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS AVENDANO",
        "first_name": "ROSA",
        "middle_name": "ESMERALDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125070190",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Falls, MN

Sources for this page

Verify at the official NPI Registry.