NPIMap

Organization Active NPI

Healtheast Medical Research Institute

Doing business as HealthEast Grand Avenue Clinic

  • Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1730128398
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HEALTHEAST MEDICAL RESEARCH INSTITUTE
Doing business as
HealthEast Grand Avenue Clinic
Practice address
870 Grand Ave
Saint Paul, MN 55105-3291
Phone
(651) 326-5650
Fax
(651) 326-5671
NPI assigned
Jun 6, 2006
Last updated
Feb 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTHEAST MEDICAL RESEARCH INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

870 Grand Ave
Saint Paul, MN 55105-3291

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other identifiers 2

IdentifierTypeStateIssuer
500719400MedicaidMN
0841630019OtherMNMEDICARE PTAN

Other names 1

  • HealthEast Grand Avenue Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000507 MN Part B Supplier - Clinic/Group Practice 3971407636 Receives reassigned benefits from 2,702 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Paul, MN; St Paul, MN; Stillwater, MN; Vadnais Heights, MN; Woodbury, MN; Cottage Grove, MN; Maplewood, MN; Oakdale, MN…

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory
Part of
Healtheast Gallery Int

Locations

1690 University Ave W
Ste 315B
Saint Paul, MN 55104
Phone (651) 326-5252

Practitioners & affiliated clinicians

Practitioners 172

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 172

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1730128398",
    "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",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053291",
            "telephone_number": "651-326-5650",
            "fax_number": "651-326-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHEAST MEDICAL RESEARCH INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTHEAST MEDICAL RESEARCH INSTITUTE",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500719400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0841630019",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthEast Grand Avenue Clinic",
            "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 Feb 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.