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MY MEDICAL CLINIC PLLC
NPI 1215344742
Clinic/Center - Multi-Specialty in Maplewood, MN

Active since July 16, 2014CLIA 24D2087511 · Waiver
1560 BEAM AVE, MAPLEWOOD, MN 55109(651) 484-6923 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1215344742
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMY MEDICAL CLINIC PLLC
Location Address1560 BEAM AVEMaplewood, MN 55109-1191
Mailing Address4872 Steeplechase WayEagan, MN 55122-2978 · (651) 484-6923
Phone(651) 484-6923
Organization SubpartNo
Authorized OfficialChaitanya AnandCmd/founder And Owner · (651) 484-6923
Enumeration DateJuly 16, 2014
Last NPPES UpdateOctober 12, 2022
NPPES CertifiedOctober 12, 2022
✔ NPI 1215344742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in MN · 45908
1560 BEAM AVE, Maplewood, MN 55109
Open in Google Maps ↗

Secondary Practice Locations 2

Location 14130 Blackhawk Rd Ste 112Eagan, MN 55122-1700 · Phone (651) 484-6923
Location 212805 Hwy 55 Ste 125Plymouth, MN 55441-3861 · Phone (651) 340-1445

Accepted Insurance

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

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, MN
Active · expires Nov 24, 2026
CLIA Number24D2087511
Laboratory TypePhysician Office
Certificate Effective DateNovember 25, 2024
Certificate Expiration DateNovember 24, 2026
Laboratory DirectorChaitanya Anand
Laboratory Phone(000) 612-4062
Laboratory LocationMy Medical Clinic1560 Beam Ave Suite F, Maplewood, MN 55109
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

BRANDI SUE MEYER LAT,PTA
Physical Therapy Assistant
1560 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 767-1756
DR. MIKE R HENRICKSON DDS
Dentist (General Practice)
1560 BEAM AVE, SUITE 2
MAPLEWOOD, MN 55109
Ramsey County (651) 777-8900
KYLE DANIELSON D.D.S.
Dentist
1560 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 777-8900
MYRON HENRICKSON, DDS PA
Dentist
1560 BEAM AVE, SUITE 2
MAPLEWOOD, MN 55109
Ramsey County (651) 777-8900
TOTIANNA RENEE PRUDHOMME NP
Nurse Practitioner (Acute Care)
1560 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 779-7978
BHAVANA C ANAND MD
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
1560 BEAM AVE, SUITE F
MAPLEWOOD, MN 55109
Ramsey County (651) 340-1445
PAUL ROBERT DUXBURY PT
Physical Therapist (Orthopedic)
1560 BEAM AVE, SUITE D
MAPLEWOOD, MN 55109
Ramsey County (651) 767-1756

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 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.

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.

What insurance does My Medical Clinic PLLC accept?

Health plans from Medica list My Medical Clinic PLLC 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 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 3 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.