DIAMOND LAKE CLINIC, P.C.
NPI 1740669498
Clinic/Center - Health Service in Minneapolis, MN
About Diamond Lake Clinic, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIAMOND LAKE CLINIC, P.C. (NPI 1740669498) is a healthcare organization registered as a health service in Minneapolis, Minnesota and active in the NPI registry since May 2015. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Saint Paul, and lists Chukwuemeka Alexander Anyake, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Location 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)
Diamond Lake Clinic, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Diamond Lake Clinic, P.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (12)
Minneapolis, MN 55417
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 2
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 24D2279169
Diamond Lake Clinic · Minneapolis, MNCertificate of Waiver 24D2320380
Diamond Lake Clinic - St Paul · Saint Paul, 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 Diamond Lake Clinic, P.C.'s NPI number?
The NPI number for Diamond Lake Clinic, P.C. is 1740669498. It was assigned to this organization in the NPPES registry on May 27, 2015.
Where is Diamond Lake Clinic, P.C. located?
Diamond Lake Clinic, P.C. is located at 5939 Portland Ave, Minneapolis, MN 55417. The listed phone number is (612) 806-3011.
What is Diamond Lake Clinic, P.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Diamond Lake Clinic, P.C. enrolled in Medicare?
Yes. Diamond Lake Clinic, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Diamond Lake Clinic, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 4 Medicare specialties reassign their Medicare billing to Diamond Lake Clinic, P.C.. 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 (8), Clinical Social Worker (2) and Certified Clinical Nurse Specialist (CNS) (1). Of these, 2 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Diamond Lake Clinic, P.C. hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Diamond Lake Clinic, P.C. accept?
Health plans from HealthPartners list Diamond Lake Clinic, P.C. 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 Diamond Lake Clinic, P.C. was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Diamond Lake Clinic, P.c. · NPI 1740669498
Health Service organization in Minneapolis, Minnesota. Organization record, active in the CMS NPPES registry since May 27, 2015.
## Identity
- **NPI:** 1740669498 (Entity type: Organization)
- **Enumerated:** May 27, 2015
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Chukwuemeka Anyake, PHYSICIAN
## Practice location
- **Address:** 5939 PORTLAND AVE, Minneapolis, MN 55417-3127
- **Phone:** (612) 806-3011
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Clinical Social Worker (2), Certified Clinical Nurse Specialist (CNS) (1); 2 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 1, 2025
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1740669498) · Data from the CMS NPPES public registry.