CMS-1500 Box 24J / 33a • NPI
1366639460
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207RC0000X (CMS 06)
Board-Certified Cardiologist (Heart & Blood Vessel Specialist)
Box 32 Service Location & ZIP+4
4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN, 55433-4568
✓ 9-Digit EDI 837 ZIP+4 (55433-4568)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1366639460 (ALLINA HEALTH SYSTEM) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1366639460 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ALLINA HEALTH SYSTEM |
| Plain-English Specialty | Board-Certified Cardiologist (Heart & Blood Vessel Specialist) NUCC Code: 207RC0000X (Internal Medicine, Cardiovascular Disease) |
| Certifying / Licensing Body | American Board of Internal Medicine — Cardiovascular Disease |
| Practice Location Address | 4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN, 55433-4568 |
| Practice Telephone / Fax | Tel: (763) 427-9980 |
| Administrative Mailing Address | PO BOX 43, MINNEAPOLIS, MN, 55440-0043 |
| Enumeration & Last Sync | Enumerated: 2007-10-02 | CMS Record Updated: 2025-01-22 |
| Authorized Official | DOMINICA TALLARICO (COO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207RC0000X)
What Does Taxonomy Code 207RC0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RC0000X translates to:
"Board-Certified Cardiologist (Heart & Blood Vessel Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALLINA HEALTH SYSTEM)
Typical CPT / Diagnostic Procedures:- Transthoracic Doppler Echocardiography (TTE — CPT 93306)
- 12-Lead Electrocardiogram (ECG) & Holter / Event Arrhythmia Monitoring
- Exercise Treadmill & Myocardial Perfusion Nuclear Stress Testing
- Diagnostic Coronary Angiography & Percutaneous Coronary Intervention (PCI)
- High-Intensity Statins (Atorvastatin, Rosuvastatin) & Ezetimibe
- Beta-Blockers (Metoprolol Succinate, Carvedilol, Bisoprolol)
- Sacubitril/Valsartan, Empagliflozin & Spironolactone (Heart Failure GDMT)
- Apixaban, Rivaroxaban & Clopidogrel (Atrial Fibrillation & Stent Thrombosis Prevention)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: N/A | License: Verified | Primary: Yes (Primary) |
261Q00000X — Clinic/CenterPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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