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SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
NPI 1679690952
Family Medicine in Minneapolis, MN

Active since March 23, 2007
1000 E LAKE ST, MINNEAPOLIS, MN 55407(612) 822-9030(612) 821-2818 Get Directions Write a Review

NPPES record last updated: August 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 7, 2026, Jan 5, 2026 (2 updates tracked since 2026).

About Southside Community Health Services, Inc. NPPES

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

SOUTHSIDE COMMUNITY HEALTH SERVICES, INC. (NPI 1679690952) is a healthcare organization registered as a family medicine in Minneapolis, Minnesota and active in the NPI registry since March 2007. The organization lists Ann Cazaban, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1679690952
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
Location Address1000 E LAKE STMinneapolis, MN 55407-1617
Mailing Address4243 4th Ave SMinneapolis, MN 55409-2113 · (612) 821-2003 · Fax (612) 821-2818
Phone(612) 822-9030
Fax(612) 821-2818
Organization SubpartNo
Authorized OfficialAnn CazabanExecutive Director · (612) 827-7181
Enumeration DateMarch 23, 2007
Last NPPES UpdateAugust 7, 20262 updates tracked since enumeration
NPPES CertifiedAugust 7, 2026
✔ NPI 1679690952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1000 E LAKE ST, Minneapolis, MN 55407
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Other Names 1

Other NameSouthside Vision Clinic

Other Identifiers 1

Medicaid515753600MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southside Community Health Services, Inc. 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 Southside Community Health Services, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Victoria Valena, APRN, CNP
Nurse Practitioner
NPI 1851360671
7430 WENTWORTH AVE
Richfield, MN 55423
(612) 488-0040
✔ PECOS✔ Accepts Medicare5.7 mi

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 Southside Community Health Services, Inc.'s NPI number?

The NPI number for Southside Community Health Services, Inc. is 1679690952. It was assigned to this organization in the NPPES registry on March 23, 2007. The provider is also known as Southside Vision Clinic.

Where is Southside Community Health Services, Inc. located?

Southside Community Health Services, Inc. is located at 1000 E Lake St, Minneapolis, MN 55407. The listed phone number is (612) 822-9030.

What is Southside Community Health Services, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Southside Community Health Services, Inc. enrolled in Medicare?

Yes. Southside Community Health Services, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southside Community Health Services, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Southside Community Health Services, Inc.. 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.

When was this NPI record last updated?

The NPPES record for Southside Community Health Services, Inc. was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.