PARK TERRACE ASSISTED LIVING, INC.
NPI 1154506368
Assisted Living Facility in Buffalo, MN

NPI Status: Active since January 07, 2008

Contact Information

613 MONTROSE BLVD
BUFFALO, MN
ZIP 55313
Phone: (763) 684-4866
Fax: (763) 682-6855

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 24D1075989
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 11-01-2025

About PARK TERRACE ASSISTED LIVING, INC.

This page provides the complete NPI Profile along with additional information for Park Terrace Assisted Living, Inc., a provider established in Buffalo, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1154506368 assigned on January 2008. The practitioner's primary taxonomy code is 310400000X with license number 337997 (MN). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Seelochani Stadtherr (Associate Vp Of Revenue Cycle Mgmt)

NPI
1154506368
Provider Legal Name
PARK TERRACE ASSISTED LIVING, INC.
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
613 MONTROSE BLVD BUFFALO, MN 55313
Location Phone
(763) 684-4866
Location Fax
(763) 682-6855
Mailing Address
613 MONTROSE BLVD BUFFALO, MN 55313
Mailing Phone
(763) 684-4866
Mailing Fax
(763) 682-6855
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-07-2008
Last Update Date
11-21-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
337997
License State
MN
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SEELOCHANI STADTHERR

Authorized Official Title
ASSOCIATE VP OF REVENUE CYCLE MGMT
Authorized Official Phone
(952) 855-5041

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
766470000MEDICAID (05)MN 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D1075989
Facility Type
Assisted Living Facility
Certificate Effective Date
November 02, 2023
Certificate Expiration Date
November 01, 2025
Laboratory Director
LAURYN COTTRELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Park Terrace Assisted Living, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1154506368, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 42. The final step is to find the difference between that total and the next multiple of ten (50 - 42 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 1 + 0 + 0 + 1 + 2 + 3 + 1 + 2 + 24 = 42

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 42 is 50. The difference is the calculated check digit.

50 - 42 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1154506368.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154506368, enumerated as an "organization" on January 07, 2008.

The provider is located at 613 MONTROSE BLVD BUFFALO, MN 55313 and the phone number is (763) 684-4866.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.