NORTHERN WATERS CLINIC
NPI 1316445455
Clinic/Center - Mental Health (Including Community Mental Health Center) in Hermantown, MN
About Northern Waters Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHERN WATERS CLINIC (NPI 1316445455) is a healthcare organization registered as a mental health (including community mental health center) in Hermantown, Minnesota and active in the NPI registry since January 2018. The organization maintains a secondary practice location in Duluth and lists Melissa Ann Maki, Co-owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northern Waters Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Northern Waters Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Hermantown, MN 55811
Hermantown, MN 55811
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Northern Waters Clinic's NPI number?
The NPI number for Northern Waters Clinic is 1316445455. It was assigned to this organization in the NPPES registry on January 23, 2018.
Where is Northern Waters Clinic located?
Northern Waters Clinic is located at 4899 Miller Trunk Hwy Ste 208, Hermantown, MN 55811. The listed phone number is (218) 391-9860.
What is Northern Waters Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Northern Waters Clinic enrolled in Medicare?
Yes. Northern Waters Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northern Waters Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Northern Waters Clinic. 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 Clinical Social Worker (3), Mental Health Counselor (3) and Nurse Practitioner (2). Of these, 2 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Northern Waters Clinic accept?
Health plans from Aspirus Health Plan and HealthPartners list Northern Waters Clinic 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 Northern Waters Clinic was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Northern Waters Clinic · NPI 1316445455
Mental Health (Including Community Mental Health Center) organization in Hermantown, Minnesota. Organization record, active in the CMS NPPES registry since January 23, 2018.
## Identity
- **NPI:** 1316445455 (Entity type: Organization)
- **Enumerated:** January 23, 2018
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Also known as:** Northern Waters Clinic (Other Name)
- **Organization subpart:** No
- **Authorized official:** Melissa Maki, CO-OWNER
## Practice location
- **Address:** 4899 MILLER TRUNK HWY STE 208, Hermantown, MN 55811-1582
- **Phone:** (218) 391-9860 · **Fax:** (218) 391-9860
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (3), Mental Health Counselor (3), Nurse Practitioner (2); 2 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 4, 2025
- **Other identifiers:** Medicaid 1295014520 (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1316445455) · Data from the CMS NPPES public registry.