Ortonville Area Health Services

Organization Active NPI Critical Access Hospital · Ortonville, MN

NPI 1790783587 · NPPES record last updated Sep 26, 2018

Key facts

NPI
1790783587
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
350419
Legal business name
ORTONVILLE AREA HEALTH SERVICES
Practice address
450 Eastvold Ave
Ortonville, MN 56278-1252
Phone
(320) 839-2502
Fax
(320) 839-4105
NPI assigned
Jul 14, 2005
Organization subpart
No

Authorized official

Name
Mr. David Rogers
Title
Administrator
Phone
(320) 839-2502

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 7

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 24

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

Affiliated clinicians 67

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 67

Medicare Care Compare: Hospital

Listed as
Ortonville Area Health Services CCN 241342
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Hospital certification: CCN 241342

Legal name
ORTONVILLE AREA HEALTH SERVICES
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2002
Last certification
Aug 16, 2018
Beds
29 (25 certified)
Ownership / control type
Local
Organization structure
Other · Non-profit
Enrollment address
450 Eastvold Ave
Ortonville, MN 56278-1252

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Allan E Ross
Individual
Corporate Officer
Ceo
Aug 31, 2022
Shane Michael Ayres
Individual
Corporate Officer
Cfo
Oct 9, 2018
City of Ortonville
Organization · Ortonville, MN
5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Nicole Lovgren
Individual
W-2 Managing Employee
Director of Nursing
Jan 21, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20061006000515 MN Part a Provider - Critical Access Hospital 2365448768 Receives reassigned benefits from 17 practitioners
Practice locations: Ortonville, MN

National Provider Directory

Tax ID family
Ortonville Area Health (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 350419 Yes

Addresses

Primary practice location

450 Eastvold Ave
Ortonville, MN 56278-1252

Mailing address

450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (320) 839-2502

Other identifiers

IdentifierTypeStateIssuer
984545300MedicaidMN
3175OtherMNHEALTH PARTNERS
5025407OtherMNMEDICA
512431OtherMNAMERICA'S PPO/ARAZ PROVID
117121841OtherMNPRIMEWEST
01014272OtherMNPREFERRED ONE
6340680OtherMNAETNA PROVIDER NUMBER
300696OtherMNUCARE
5520390MedicaidSD
0120390MedicaidSD
1790HOROtherMNBLUE CROSS BLUE SHIELD

Other providers in Ortonville, MN

All providers in Ortonville, MN · Critical Access Hospital in Minnesota

Sources for this page

Verify at the official NPI Registry.