MY MEDICAL CLINIC PLLC
NPI 1215344742
Clinic/Center - Multi-Specialty in Maplewood, MN
About My Medical Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MY MEDICAL CLINIC PLLC (NPI 1215344742) is a healthcare organization registered as a multi-specialty in Maplewood, Minnesota and active in the NPI registry since July 2014. The organization holds a CLIA Waiver certificate valid through November 24, 2026, maintains 2 additional practice locations, and lists Chaitanya Anand, Cmd/founder And Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
My Medical Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to My Medical Clinic PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 Waiver 24D2087511
My Medical Clinic · Maplewood, MNFrequently 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 My Medical Clinic PLLC's NPI number?
The NPI number for My Medical Clinic PLLC is 1215344742. It was assigned to this organization in the NPPES registry on July 16, 2014.
Where is My Medical Clinic PLLC located?
My Medical Clinic PLLC is located at 1560 Beam Ave, Maplewood, MN 55109. The listed phone number is (651) 484-6923.
What is My Medical Clinic PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is My Medical Clinic PLLC enrolled in Medicare?
Yes. My Medical Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through My Medical Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to My Medical Clinic PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does My Medical Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2087511) is associated with this NPI, valid through November 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for My Medical Clinic PLLC was last updated on October 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# My Medical Clinic Pllc · NPI 1215344742
Multi-Specialty organization in Maplewood, Minnesota. Organization record, active in the CMS NPPES registry since July 16, 2014.
## Identity
- **NPI:** 1215344742 (Entity type: Organization)
- **Enumerated:** July 16, 2014
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Chaitanya Anand, CMD/FOUNDER AND OWNER
## Practice location
- **Address:** 1560 BEAM AVE, Maplewood, MN 55109-1191
- **Phone:** (651) 484-6923
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 12, 2022
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1215344742) · Data from the CMS NPPES public registry.