Park Nicollet Methodist Hospital
Organization Active NPI General Acute Care Hospital · St Louis Park, MN
NPI 1942585286 · NPPES record last updated Aug 3, 2026
Key facts
- NPI
- 1942585286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 350048 (MN)
- Legal business name
- PARK NICOLLET METHODIST HOSPITAL
- Practice address
- 3525 Monterey Dr
St Louis Park, MN 55416-5275 - Phone
- (952) 993-1990
- Fax
- (952) 993-1980
- NPI assigned
- Oct 19, 2011
- Organization subpart
- No
Authorized official
- Name
- Alita Risinger
- Title
- Sr Vice President, Cfo
- Phone
- (952) 883-5401
Owners & managing parties with NPI records 4
-
Jerome C Siy, MD
-
Rae Ann Williams, MD
-
Bradley B Wozney, MD
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 11
Affiliated clinicians 1,790
-
Kirk Aadalen, M.D.
-
Kyle Wayne Abben, DPM
-
Alissa Marie Abraham, DNP, APRN, AGNP-C
-
Maggie Abraham, MD
-
Oluwaseun Acquah, M.D.
-
Alison K Adams, M.D.
-
Roderick Adams, MD
-
Isaac Adediran, M.D
-
Nima M Adimi, MD
-
Melissa Ann Adler, LICSW
-
Sada A Ahmed, DNP, CNP, AGNP-C
-
Umair Ahmed, M.D.
-
Michael T Akin, M.D.
-
Daniel A Albright, M.D.
-
Michelle Anne Aldrich-Goldstein, APRN, CNP
Medicare Care Compare: Hospital
- Listed as
- Park Nicollet Methodist Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospital certification: CCN 240053
- Legal name
- PARK NICOLLET METHODIST HOSPITAL
- Doing business as
- METHODIST HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jan 10, 2014
- Beds
- 426
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1893 in MN
- Enrollment address
- 6500 Excelsior Blvd
St Louis Park, MN 55426-4702 - Hospital subgroups
- General, Acute care, Rehabilitation, Rehabilitation unit
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Craig Larson |
W-2 Managing Employee |
Oct 1, 2013 | |
| Rae Ann Williams |
Corporate Director | Jan 1, 2018 | |
| Robert Ehren |
Corporate Director | Jan 1, 2024 | |
| Mark R Sannes |
Corporate Officer | Jan 1, 2025 | |
| Morris Goodwin |
Corporate Director | Jan 1, 2017 | |
| Jason Luhrs |
Corporate Director |
Sep 15, 2021 | |
| Park Nicollet Health Services |
Operational/Managerial Control | Oct 23, 2007 | |
| Laura Liu |
Corporate Director | Jan 1, 2023 | |
| Kathleen a Kelley |
Corporate Director | Jan 1, 2021 | |
| Sherri Lynn Broderius |
Corporate Director | Jan 1, 2026 | |
| Bradley Wozney |
Corporate Director | Jan 1, 2019 | |
| Jerome C Siy |
Corporate Officer | Jan 1, 2026 | |
| Sharon Pierce Evan |
Corporate Director | Jan 1, 2020 | |
| Ana Lee |
Corporate Director | Jan 1, 2022 | |
| Paul D Williams |
Corporate Director | Jan 1, 2021 | |
| David Lagerstrom |
Corporate Director | Jan 1, 2022 | |
| Alita R Risinger |
Corporate Director | Apr 17, 2026 | |
| Lisa Bjorkman |
W-2 Managing Employee |
Jul 27, 2015 | |
| Mary Grove |
Corporate Director | Mar 19, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050606000573 | MN | Part a Provider - Hospital | 7315840063 |
5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saint Louis Park, MN; St Louis Park, MN; Saint Paul, MN; Maple Grove, MN; Golden Valley, MN |
National Provider Directory
- Tax ID family
- Back and Neck Clinic
Locations
3525 Monterey Dr
St Louis Park, MN 55416
Phone (952) 993-1990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 350048 | MN | Yes |
Addresses
Primary practice location
3525 Monterey Dr
St Louis Park, MN 55416-5275
Mailing address
PO Box 1488
Minneapolis, MN 55480-1488
Phone (952) 993-1990
Other names
- Park Nicollet Melrose Center
Other providers in St Louis Park, MN
- Park Nicollet Methodist Hospital
- Park Nicollet Methodist Hospital
- Park Nicollet Methodist Hospital
- Park Nicollet Methodist Hospital
- Park Nicollet Methodist Hospital
- Park Nicollet- Methodist Hospital
- Park Psychotherapy & Consulting Inc
- Gail Engasser Park
- Parkdale Therapy Group, LLC
- Erin Devine Parker
All providers in St Louis Park, MN · General Acute Care Hospital in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2026. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.