NPIMap

Organization Active NPI

Fairview Maple Grove Surgery Center, LLC

  • Anesthesiology Physician
  • Maple Grove, MN
National Provider Identifier
1730068032
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC
Practice address
14500 99TH Ave N Ste 500
Maple Grove, MN 55369-4742
Phone
(855) 324-7843
NPI assigned
Aug 29, 2025
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Maureen Ring
Title
System Director
Phone
(612) 672-6740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

14500 99TH Ave N Ste 500
Maple Grove, MN 55369-4742

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260529001873 MN Part B Supplier - Clinic/Group Practice 7416058300 Receives reassigned benefits from 21 practitioners
Practice locations: Maple Grove, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Fairview Maple Grove Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

14500 99th Ave N
Ste 500
Maple Grove, MN 55369
Phone (763) 898-1400

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1730068032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 99TH AVE N STE 500",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694742",
            "telephone_number": "855-324-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.