Allina Health System
Organization Active NPI Radiation Oncology Clinic/Center · Faribault, MN
NPI 1922535178 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1922535178
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiation Oncology Clinic/Center 261QX0203X
- Legal business name
- ALLINA HEALTH SYSTEM
- Practice address
- 200 State Ave
Faribault, MN 55021-6339 - Phone
- (507) 497-3721
- Fax
- (507) 332-4712
- NPI assigned
- May 18, 2017
- Organization subpart
- No
Authorized official
- Name
- Dominica Tallarico
- Title
- Coo
- Phone
- (612) 222-2222
Practitioners 38
-
Kari Christine Abraham, APRN, CPNP-PC
-
Joseph W. Akornor, M.D.
-
Peter N Anyona, CRNA
-
Peter R Ataro, MD
-
Brenda Joy Baker, P.A.C
-
Lisa C Baker, DNP, APRN, CRNA
-
Mekena Coakley, MS, LADC, LPCC
-
Boris Davydov, PA-C
-
Glenn Alan Gaunt, M.D.
-
Molly Mae Giebel, PA-C
-
David A Gross, M.D.
-
Shannon Marie Helget, LPCC
-
Elizabeth Rose Hofbauer, M.D.
-
Lydia Nahbila Kebila, CNP
-
Allison J Z Levy, MD
-
Janna Lowery, APRN, CNNP
-
Erin R Maguire, PA-C
-
Alyas Masih, MD
-
Rachel Louise McCaffrey, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040319000460 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 4,246 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
2925 Chicago Ave
#10860
Minneapolis, MN 55407
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Clinic/Center | 261QX0203X | Yes |
Addresses
Primary practice location
200 State Ave
Faribault, MN 55021-6339
Mailing address
PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166
Other names
- Allina Health Cancer Institute - Faribault
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service | Other | Ciox Health |
Other providers in Faribault, MN
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Marisa A Amacher
- Barbara Anderson
- Cindy Anderson
- Dean Steven Anderson
All providers in Faribault, MN · Radiation Oncology Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.