<unavail> in St Paul, MN - Medicare Family Medicine

is a medicare enrolled primary clinic (Family Medicine) in St Paul, Minnesota. The current practice location for is 1021 Bandana Blvd E, Ste 100, St Paul, Minnesota. For appointments, you can reach them via phone at (651) 241-9700. The mailing address for is Po Box 43, Mail Route 10585, Minneapolis, Minnesota and phone number is (612) 262-1166.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1023314804. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (651) 241-9700.

Contact Information


	1021 Bandana Blvd E Ste 100 St Paul MN 55108-5109
	(651) 241-9700
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Family Medicine
Location	1021 Bandana Blvd E, St Paul, Minnesota
Authorized Official Name and Position	Dominica Tallarico (COO)
Authorized Official Contact	6122222222
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 43 Mail Route 10585 Minneapolis MN 55440-0043 Ph: (612) 262-1166	1021 Bandana Blvd E Ste 100 St Paul MN 55108-5109 Ph: (651) 241-9700

NPI Details:

NPI Number	1023314804
Provider Enumeration Date	01/27/2011
Last Update Date	01/14/2025

Medicare PECOS Information:

Medicare PECOS PAC ID	4587573613
Medicare Enrollment ID	O20111216000537

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023314804	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Primary
207QS1201X	Family Medicine - Sleep Medicine	(* (Not Available))	Secondary
261QS1200X	Clinic/center - Sleep Disorder Diagnostic	(* (Not Available))	Secondary
332B00000X	Durable Medical Equipment & Medical Supplies	(* (Not Available))	Secondary

Reviews and Comments

Family Medicine in St Paul, MN

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- Medicare Primary Care in St Paul, MN