Minnesota Allergy & Asthma LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

MINNESOTA ALLERGY & ASTHMA LLC

Practice address

6550 York Ave S Ste 112
Edina, MN 55435-2332

Phone

(952) 746-1854

Fax

(612) 339-1854

NPI assigned

Feb 12, 2007

Last updated

Oct 27, 2024By 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

Barbra Simmons

Title

Credentialing Manager

Phone

(517) 936-8566

Specialties & licenses 2

Addresses

Other names 1

• Eisenstadt Allergy & Asthma LLP Former legal business name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

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.

• Kyah Fons Miles

  • Physician Assistant
  • Saint Paul, MN
  • NPI 1043512445
  Medicare reassignment Care Compare group
• Ramarathinam Nagarajan, MD PHD

  • Allergy & Immunology Physician
  • Minneapolis, MN
  • NPI 1689636482
  Medicare reassignment Care Compare group
• Lauren Callis, LPCC, ATR

  • Mental Health Counselor
  • Edina, MN
  • NPI 1740062066
  NPD (past)
• Kristen E Orazem, MSW, LICSW

  • Clinical Social Worker
  • Edina, MN
  • NPI 1346599586
  NPD (past)
• Heather Stras, MSW, LICSW

  • Clinical Social Worker
  • Edina, MN
  • NPI 1760029730
  NPD (past)
• Esther Maryvonne Vogelzang, MSW, LICSW

  • Clinical Social Worker
  • Woodbury, MN
  • NPI 1710559703
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729987200000",
    "number": "1881736544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 112",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352332",
            "telephone_number": "952-746-1854",
            "fax_number": "527-461-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 112",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352332",
            "telephone_number": "952-746-1854",
            "fax_number": "612-339-1854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20520 Keokuk Ave Ste 180",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550446456",
            "country_code": "US",
            "telephone_number": "952-898-2212",
            "fax_number": "952-898-2240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINNESOTA ALLERGY & ASTHMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "BARBRA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "517-936-8566"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mmdas.modulemd.com/",
            "affiliation": "N",
            "endpointDescription": "EHR with encrypted messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCR",
            "address_1": "6550 York Ave S Ste 112",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554352332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mmdas.modulemd.com/",
            "affiliation": "N",
            "endpointDescription": "EHR with encrypted messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCR",
            "address_1": "6550 York Ave S Ste 112",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554352332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eisenstadt Allergy & Asthma LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Allergy & Immunology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Allergy & Immunology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2024; 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.