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PEDIATRIC AND YOUNG ADULT MEDICINE, PA
NPI 1295977395
Clinic/Center - Primary Care in Maplewood, MN

Active since April 03, 2009CLIA 24D0399350 · Accreditation
1655 BEAM AVE, SUITE 108, MAPLEWOOD, MN 55109(651) 256-6706(651) 256-6707 Get Directions Write a Review

NPPES record last updated: December 7, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediatric And Young Adult Medicine, Pa NPPES

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

PEDIATRIC AND YOUNG ADULT MEDICINE, PA (NPI 1295977395) is a healthcare organization registered as a primary care in Maplewood, Minnesota and active in the NPI registry since April 2009. The organization holds an CLIA Accreditation certificate valid through December 22, 2027 and lists Terri M Joseph, Clinic Administrator, as its authorized official.

NPPES Registry Identity

NPI1295977395
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePEDIATRIC AND YOUNG ADULT MEDICINE, PA
Location Address1655 BEAM AVE, SUITE 108Maplewood, MN 55109-1163
Mailing Address1804 7th St W, Suite 200Saint Paul, MN 55116-2300 · (651) 256-6706 · Fax (651) 256-6710
Phone(651) 256-6706
Fax(651) 256-6707
Organization SubpartNo
Authorized OfficialTerri M JosephClinic Administrator · (651) 256-6706
Enumeration DateApril 3, 2009
Last NPPES UpdateDecember 7, 2016
✔ NPI 1295977395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MN · 154
1655 BEAM AVE, Maplewood, MN 55109
Open in Google Maps ↗

Other Identifiers 10

Medicaid1245210095MN
Medicaid1477870921MN
Medicaid1083694046MN
Medicaid1104806165MN
Medicaid1912987900MN
Medicaid1881057065MN
Medicaid1386991339MN
Medicaid1861558835MN
Medicaid1497735419MN
Medicaid1245210210MN

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 Accreditation 24D0399350

Pediatric And Young Adult Medicine · Maplewood, MN
Active · expires Dec 22, 2027
CLIA Number24D0399350
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorTammi Plotnik
Laboratory Phone(651) 256-6754
Laboratory LocationPediatric And Young Adult Medicine1965 11th Avenue E Suite 102, Maplewood, MN 55109
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.

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.

AARON KURTISS KIRKEMO M.D.
Urology
1655 BEAM AVE, SUITE 206
MAPLEWOOD, MN 55109
Ramsey County (651) 999-6896
JAMES R SNYDER PA
Physician Assistant
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7831
RHONDA S FENDER NNP
Nurse Practitioner (Neonatal)
1655 BEAM AVE, SUITE 302
MAPLEWOOD, MN 55109
Ramsey County (651) 232-7031
VIRGINIA L REUTIMAN CRNA
Nurse Anesthetist, Certified Registered
1655 BEAM AVE
SAINT PAUL, MN 55109
Ramsey County (651) 735-0501
MARY L HASECUSTER CRNA
Nurse Anesthetist, Certified Registered
1655 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 735-0501
JULIE A JOHNSON CRNA
Nurse Anesthetist, Certified Registered
1655 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 735-0501
ALANA H HOWEY PT
Physical Therapist
1655 BEAM AVE, SUITE 309
MAPLEWOOD, MN 55109
Ramsey County (651) 779-6543
GAYLA MARIE PLEGGENKUHLE PT
Physical Therapist
1655 BEAM AVE, SUITE 309
MAPLEWOOD, MN 55109
Ramsey County (651) 779-6543

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 Pediatric And Young Adult Medicine, PA's NPI number?

The NPI number for Pediatric And Young Adult Medicine, PA is 1295977395. It was assigned to this organization in the NPPES registry on April 3, 2009.

Where is Pediatric And Young Adult Medicine, PA located?

Pediatric And Young Adult Medicine, PA is located at 1655 Beam Ave Suite 108, Maplewood, MN 55109. The listed phone number is (651) 256-6706.

What is Pediatric And Young Adult Medicine, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Pediatric And Young Adult Medicine, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 24D0399350) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric And Young Adult Medicine, PA was last updated on December 7, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.