Allina Health System

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ALLINA HEALTH SYSTEM

Doing business as

Allina Health Maple Grove Clinic

Practice address

7840 Vinewood LN N
Maple Grove, MN 55369-7185

Phone

(763) 236-0200

Fax

(763) 420-5531

NPI assigned

Feb 2, 2011

Last updated

Feb 25, 2025By the provider in NPPES

Organization subpart

No

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 1

Addresses

Other names 1

• Allina Health Maple Grove Clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN3 enrollments

Enrollment records 3

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

All facility ownership & control disclosures 3

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

Practitioners 29

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.

• Justin J Baker, MD

  • Surgery Physician
  • Saint Paul, MN
  • NPI 1366523417
  NPD
• Jase Bakker

  • Student in an Organized Health Care Education/Training Program
  • Vadnais Heights, MN
  • NPI 1710782974
  NPD
• Selina A Barby

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1801541412
  NPD
• Curt L Behrns, M.D.

  • Diagnostic Radiology Physician
  • Roseville, MN
  • NPI 1801869227
  NPD
• Chen Thay Chau, M.D.

  • Critical Care Medicine (Anesthesiology) Physician
  • Minneapolis, MN
  • NPI 1992061519
  NPD
• Joseph M Dauwalter, NP-C

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
  • NPI 1851689772
  NPD
• Sharena Deonarain, D.C.

  • Chiropractor
  • Shakopee, MN
  • NPI 1619990199
  NPD
• William Christpher Downey, MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Minneapolis, MN
  • NPI 1891723359
  NPD
• Jeremiah Douglas Fairbanks, DO

  • Family Medicine Physician
  • Hastings, MN
  • NPI 1770016453

  Single Specialty

  NPD
• Amy Lynn Haupert, MD

  • Family Medicine Physician
  • Cambridge, MN
  • NPI 1962462788
  NPD
• John R Hering, MD

  • Family Medicine Physician
  • Monticello, MN
  • NPI 1124048251
  NPD
• Anne Hope

  • Nurse Practitioner
  • St Louis Park, MN
  • NPI 1164686291
  NPD

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1730485186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MAIL ROUTE 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": "7840 VINEWOOD LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697185",
            "telephone_number": "763-236-0200",
            "fax_number": "763-420-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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": "Allina Health Maple Grove Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allina Health Maple Grove Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bushra Irad Ali
• Ella Allanson
• Allergy and Asthma Care, PA
• Sydnee Allie-Lindquist
• Allied Endodontic Specialists, P.a.
• Dominic John Allocco, MD
• Bryan D Alm, DPT
• Echo Anne Althoff
• Baird C. Alwin, D.D.S.
• Amecote Home Care Services Inc

• Clinic/Center in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.