ALLINA HEALTH EAST LAKE STREET CLINIC
NPI 1285930065
Family Medicine in Minneapolis, MN
About Allina Health East Lake Street Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALLINA HEALTH EAST LAKE STREET CLINIC (NPI 1285930065) is a healthcare organization registered as a family medicine in Minneapolis, Minnesota and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through September 19, 2028 and lists Dominica Tallarico, Coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Allina Health East Lake Street Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4,538Medicare enrollment records show 4,538 clinicians reassign Medicare billing to Allina Health East Lake Street Clinic, which bills Medicare for the services they deliver. Of these, 14 practice at this address and 2,386 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 68
Nearest to this location (20)
See all 4,538Minneapolis, MN 55406
Minneapolis, MN 55407
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 24D0401292
Allina Health East Lake Street Clinic · Minneapolis, 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 Allina Health System's NPI number?
The NPI number for Allina Health System is 1285930065. It was assigned to this organization in the NPPES registry on January 27, 2011. The provider is doing business as Allina Health East Lake Street Clinic.
Where is Allina Health System located?
Allina Health System is located at 3024 Snelling Ave S, Minneapolis, MN 55406. The listed phone number is (612) 775-4900.
What is Allina Health System's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Allina Health System enrolled in Medicare?
Yes. Allina Health System is registered in the Medicare PECOS enrollment system.
When is Allina Health System's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Minnesota, Physician - Unknown Physician Specialty) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Allina Health System?
According to the CMS Revalidation Reassignment List (October 2026 release), 4,538 clinicians in 68 Medicare specialties reassign their Medicare billing to Allina Health System. 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. The largest specialties are Nurse Practitioner (785), Family Practice (536) and Internal Medicine (467). Of these, 14 practice at this address and 2,386 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Allina Health System hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D0401292) is associated with this NPI, valid through September 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Allina Health System accept?
Health plans from HealthPartners 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 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Allina Health East Lake Street Clinic · NPI 1285930065
Family Medicine organization in Minneapolis, Minnesota. Organization record, active in the CMS NPPES registry since January 27, 2011.
## Identity
- **NPI:** 1285930065 (Entity type: Organization)
- **Enumerated:** January 27, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Allina Health System
- **Organization subpart:** No
- **Authorized official:** Dominica Tallarico, COO
## Practice location
- **Address:** 3024 SNELLING AVE S, Minneapolis, MN 55406-1911
- **Phone:** (612) 775-4900 · **Fax:** (612) 728-1621
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (DME, Minnesota, Physician - Unknown Physician Specialty) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4,538 clinicians in 68 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (785), Family Practice (536), Internal Medicine (467); 14 practice at this address and 2,386 within 10 miles; [full list](https://npiprofile.com/npi/1285930065/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1285930065) · Data from the CMS NPPES public registry.