NPIMap

Organization Active NPI

North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
National Provider Identifier
1841995552
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTH MEMORIAL HEALTH CARE
Practice address
4181 108TH Ave NE Ste 200
Blaine, MN 55449-7439
Phone
(763) 581-0555
NPI assigned
Apr 3, 2023
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH MEMORIAL HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Stephanie R Gale
Title
Interim Cfo
Phone
(763) 581-4635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

4181 108TH Ave NE Ste 200
Blaine, MN 55449-7439

Mailing address

PO Box 735463
Chicago, IL 60673-5463

Other names 1

  • NORTH MEMORIAL HEALTH RHEUMATOLOGY - BLAINE Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080417000620 MN Part A Provider - Hospital 0042123028 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blaine, MN; Brooklyn Center, MN; Maple Grove, MN; Robbinsdale, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841995552. Details of each certification follow.

Hospital certification: CCN 240001

Legal name
NORTH MEMORIAL HEALTH CARE
Doing business as
NORTH MEMORIAL HEALTH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 6, 2019
Beds
518
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1940 in MN
Enrollment address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
North Memorial Health HospitalCCN 240001 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Bass Lake Physicians7 organizations share this tax ID, including this one
Part of
Bass Lake Physicians

Other organizations with this tax ID 6

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

Locations (25 of 28)

1420 109th Ave NE
Ste 100
Blaine, MN 55449
Phone (763) 571-5550

4181 108th Ave NE
Ste 200
Blaine, MN 55449
Phone (763) 581-0555

5615 Xerxes Ave N
Ste D
Brooklyn Center, MN 55430
Phone (763) 581-5630

305 E Nicollet Blvd
Ste 372
Burnsville, MN 55337
Phone (952) 460-4130

1970 Rahncliff Ct
Eagan, MN 55122
Phone (651) 686-6442

8301 Golden Valley Rd
Ste 150
Golden Valley, MN 55427
Phone (763) 520-3898

8301 Golden Valley Rd
Ste 201
Golden Valley, MN 55427
Phone (763) 581-6460

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

12000 Elm Creek Blvd N
Ste 210
Maple Grove, MN 55369
Phone (763) 420-7002

7270 Forestview Ln N
Ste 100
Maple Grove, MN 55369

9825 Hospital Dr
Ste 200
Maple Grove, MN 55369
Phone (763) 581-5400

9855 Hospital Dr
Ste 102
Maple Grove, MN 55369
Phone (763) 581-5800

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9855 Hospital Dr
Ste 175
Maple Grove, MN 55369
Phone (763) 581-1000

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

1229 2nd St NE
Minneapolis, MN 55413
Phone (612) 379-1119

327 Central Ave SE
Minneapolis, MN 55414
Phone (612) 379-1119

651 Nicollet Mall
Ste 277
Minneapolis, MN 55402
Phone (763) 581-0907

15450 Highway 7
Ste 100
Minnetonka, MN 55345
Phone (763) 581-8900

2000 Plymouth Rd
Ste 100
Minnetonka, MN 55305
Phone (763) 581-5250

1001 Hart Blvd
Ste 150
Monticello, MN 55362
Phone (320) 656-7020

8100 42nd Ave N
New Hope, MN 55427
Phone (763) 581-5700

7180 10th St N
Oakdale, MN 55128
Phone (651) 242-5890

3300 Oakdale Ave N
Apt 180
Robbinsdale, MN 55422
Phone (763) 581-5140

3300 Oakdale Ave N
Rm Physicians
Robbinsdale, MN 55422

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Diane Huston Individual Corporate DirectorBoard Member Jan 1, 2019
Ramon Alfredo Pastrano Individual Corporate DirectorBoard Member Aug 22, 2024
Eric Jerome Skalland Individual Corporate DirectorBoard Member Aug 22, 2024
Stephanie Renee Gale Individual Corporate OfficerCfo Dec 2, 2024
Alexa Chellsen Individual W-2 Managing EmployeeManager Rev Cycle System Billing Aug 1, 2020
Laurie Lafontaine Individual Corporate DirectorBoard Member Jul 1, 2016
Heidi M Wilson Individual Corporate DirectorBoard Member Jan 1, 2019
Cameron Keith Berg Individual Corporate DirectorBoard Member Aug 22, 2024
Ted Ferrara Individual Corporate DirectorBoard Member Jul 1, 2016
John Foley Individual W-2 Managing EmployeeManager Payer Strategy and Relation Sep 7, 2022
Andrew J Houlton Individual Corporate DirectorBoard Member Feb 18, 2021
Carolyn Ogland Vukich Individual Corporate DirectorCmo Aug 20, 2018
W-2 Managing EmployeeCmo Aug 20, 2018
Reuben Moore Individual Corporate DirectorBoard Member Jan 1, 2021
Trevor W Sawallish Individual Corporate OfficerCeo Sep 1, 2023
Robert Mahlon Dahl Individual Corporate DirectorBoard Member Jan 1, 2018
Warren Mack Individual Corporate DirectorBoard Member Aug 1, 2013
Allen Kemp Individual Corporate DirectorBoard Member Aug 22, 2024
Bruce Christensen Individual Corporate DirectorBoard Member Jan 1, 2019

Practitioners & affiliated clinicians

Practitioners 699

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 699

Affiliated clinicians 1,250

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

View all 1,250

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1841995552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735463",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 108TH AVE NE STE 200",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497439",
            "telephone_number": "763-581-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MEMORIAL HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH MEMORIAL HEALTH CARE",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "GALE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "INTERIM CFO",
        "authorized_official_telephone_number": "763-581-4635"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH MEMORIAL HEALTH RHEUMATOLOGY - BLAINE",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NORTH MEMORIAL HEALTH RHEUMATOLOGY - BLAINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.