BLAINE MN MULTI SPECIALTY ASC LLC (NPI# 1760616031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760616031 |
| Entity Type | Organization |
| Organization Name | BLAINE MN MULTI SPECIALTY ASC LLC |
| Other Organization Name | NORTH METRO SURGERY CENTER |
| Practice Address |
11855 Ulysses St Ne Suite 270 Blaine MN 55434-3947 |
| Practice Telephone | 7637556540 |
| Mailing Telephone | 7637556540 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2013-03-13 |
| Authorized Official Name | PHILLIP A CLENDENIN (PRESIDENT) |
| Authorized Official Telephone | 6156651283 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | RAILROAD | P00825924 | 01 |
| Other Name | Type Code |
|---|---|
| North Metro Surgery Center | Doing Business As Name - Organization |
| Street Address |
11855 ULYSSES ST NE SUITE 270 |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-3947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003893066 | Stacy L Noyes | Obstetrics & Gynecology | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2005-12-29 |
| 1427606896 | David Moga | Physical Therapist | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2019-08-29 |
| 1336675560 | North Memorial Health Care | Clinic/Center | 11855 Ulysses St Ne, #110, Blaine, MN 55434-3947 | 2017-05-09 |
| 1811361603 | Pamela Rhiel | Nurse Practitioner | 11855 Ulysses St Ne, Suite 250, Blaine, MN 55434-3947 | 2015-11-17 |
| 1629405931 | Rachel Sinnen | Physician Assistant | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-10-01 |
| 1538408943 | North Memorial Health Care | Clinic/Center | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-02-05 |
| 1942547096 | Blaine Urgency Center, LLC | Clinic/Center | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-01-09 |
| 1467735407 | Carly L. Mattson | Physical Therapist | 11855 Ulysses St Ne, Ste 20, Blaine, MN 55434-3947 | 2011-09-26 |
| 1538497276 | Lori Jean Treb | Dietitian, Registered | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2009-11-18 |
| 1144462219 | Lakeland Health Services, Inc. | Durable Medical Equipment & Medical Supplies | 11855 Ulysses St Ne, Suite 205 and Suite 210, Blaine, MN 55434-3947 | 2009-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1205152618 | Minnesota Eye Laser & Surgery Centers, LLC | Clinic/Center | 11091 Ulysses Street Ne, Suite 400, Blaine, MN 55434-4237 | 2010-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079992 | Woodbury Surgery Center, LLC | Clinic/Center | 587 Bielenberg Dr Ste 100, Woodbury, MN 55125-4452 | 2020-10-09 |
| 1902410368 | Inspired Spine Surgcenter LLC | Clinic/Center | 7400 France Ave S Ste 102, Edina, MN 55435-4738 | 2020-09-03 |
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1215573209 | Hiawatha Surgery Center LLC | Clinic/Center | 2020 E 28th St Ste 100, Minneapolis, MN 55407-1453 | 2019-11-25 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1942760285 | Altru Health System Ambulatory Surgery Centers LLC | Clinic/Center | 400 S Minnesota St Ste B, Crookston, MN 56716-1808 | 2019-03-22 |
| 1396229746 | Avera Marshall | Clinic/Center | 1521 Carlson St Ste 200, Marshall, MN 56258-2626 | 2018-09-21 |
| 1891297925 | Pediatric Center Holdings, LLC | Clinic/Center | 15450 Highway 7 Ste 200, Minnetonka, MN 55345-3522 | 2018-03-05 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1265959795 | Bhatti Gi Surgery Center LLC | Clinic/Center | 1447 White Oak Dr, Chaska, MN 55318 | 2017-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.