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ALLINA HEALTH BANDANA SQUARE CLINIC
NPI 1023314804
Family Medicine in St Paul, MN

Active since January 27, 2011CLIA Certified · 2 labs
1021 BANDANA BLVD E, STE 100, ST PAUL, MN 55108(651) 241-9700 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 3, 2023, Aug 31, 2020, Nov 22, 2019 and 4 more (7 updates tracked since 2018).

About Allina Health Bandana Square Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALLINA HEALTH BANDANA SQUARE CLINIC (NPI 1023314804) is a healthcare organization registered as a family medicine in St Paul, Minnesota and active in the NPI registry since January 2011. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in St Paul, and lists Dominica Tallarico, Coo, as its authorized official.

NPPES Registry Identity

NPI1023314804
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameALLINA HEALTH SYSTEM
Location Address1021 BANDANA BLVD E, STE 100St Paul, MN 55108-5109
Mailing AddressPo Box 43, Mail Route 10585Minneapolis, MN 55440-0043 · (612) 262-1166
Phone(651) 241-9700
Organization SubpartNo
Authorized OfficialDominica TallaricoCoo · (612) 222-2222
Enumeration DateJanuary 27, 2011
Last NPPES UpdateJanuary 14, 20257 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2025
✔ NPI 1023314804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sleep MedicineTaxonomy 207QS1201X
Also ListedClinic/Center · Sleep Disorder DiagnosticTaxonomy 261QS1200X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1021 BANDANA BLVD E, St Paul, MN 55108
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Other Names 1

Doing Business AsAllina Health Bandana Square Clinic

Secondary Practice Location 1

Location 11010 Bandana Blvd E, STE 236St Paul, MN 55108-5107 · Phone (651) 641-7100

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 24D0399281

Allina Health Bandana Square Clinic · Saint Paul, MN
Active · expires Dec 22, 2027
CLIA Number24D0399281
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorJason Daniels
Laboratory Phone(651) 641-7000
Laboratory LocationAllina Health Bandana Square Clinic1021 Bandana Blvd E, Saint Paul, MN 55108
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Compliance 24D2076437

Allina Health Bandana Square Mohs Lab · Saint Paul, MN
Active · expires Mar 8, 2028
CLIA Number24D2076437
Laboratory TypePhysician Office
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorKevin N. Christensen
Laboratory Phone(651) 241-9700
Laboratory LocationAllina Health Bandana Square Mohs Lab1021 Bandana Blvd E Ste 100, Saint Paul, MN 55108
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Allina Health Bandana Square Clinic carries, from the Medicare DMEPOS supplier directory.

Allina Health Bandana Square Clinic

DMEPOS supplier · St Paul, MNOperated by Allina Health System
✔

Accepts Medicare assignment

Allina Health Bandana Square Clinic agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20678297
Medicare Participant SinceOctober 1, 1984
Supplier Location1021 Bandana Blvd E Ste 100St Paul, MN 55108
Phone(651) 241-9700
Provider TypePhysician – Unknown Physician Specialty
Supplier Specialties
Optometrist Optician

Medicare Product Categories

Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Walkers
Standard Walkers, Wheeled Walkers, Folding Walker
Wheelchairs (Standard Manual)
Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
Orthoses: Custom Fabricated
Custom met pads, Custom heel pads, Custom heel spur pads
Orthoses: Prefabricated (Non-Custom Fabricated)
Met pads, Heel pads, Heel spur pads
Orthoses: Off-The-Shelf
Met pads, Heel pads, Heel spur pads
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL JO SCHULTZ
Physician Assistant
1021 BANDANA BLVD E
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700
MRS. SUZANNE HELENE SACKETT PA-C, MHS
Physician Assistant
1021 BANDANA BLVD E, SUITE 100
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700
LAURA A MELMS DNP
Nurse Practitioner (Family)
1021 BANDANA BLVD E
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700
TERESA KIRESUK NP
Nurse Practitioner (Gerontology)
1021 BANDANA BLVD E, SUITE 200
SAINT PAUL, MN 55108
Ramsey County (651) 637-2960
DR. TAIWO ADEBOLA LAWAL M.D., M.P.H., FACP
Internal Medicine
1021 BANDANA BLVD E, STE 100
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700
KIMBERLEY MULLIN PA-C
Physician Assistant
1021 BANDANA BLVD E, SUITE 100
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700
MICHAEL H FLAMENBAUM DMD
Dentist (Pediatric Dentistry)
1021 BANDANA BLVD E, SUITE 121
SAINT PAUL, MN 55108
Ramsey County (651) 224-4969
MOHAMAD Y ABBAS M.D.
Internal Medicine (Infectious Disease)
1021 BANDANA BLVD E, STE 100
SAINT PAUL, MN 55108
Ramsey County (651) 241-9700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Allina Health System's NPI number?

The NPI number for Allina Health System is 1023314804. It was assigned to this organization in the NPPES registry on January 27, 2011. The provider is doing business as Allina Health Bandana Square Clinic.

Where is Allina Health System located?

Allina Health System is located at 1021 Bandana Blvd E Ste 100, St Paul, MN 55108. The listed phone number is (651) 241-9700.

What is Allina Health System's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Allina Health System accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Allina Health Bandana Square Clinic accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Allina Health System hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Allina Health System accept?

Health plans from HealthPartners and Medica list Allina Health System as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Allina Health System was last updated on January 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.