| Riverview Healthcare Association | |
|
1428 Central Ave Ne East Grand Forks MN 56721-1605 | |
| (218) 773-1390 | |
| (218) 773-1762 |
| Full Name | Riverview Healthcare Association |
|---|---|
| Speciality | Clinic/Center |
| Location | 1428 Central Ave Ne, East Grand Forks, Minnesota |
| Authorized Official Name and Position | Betty J Arvidson (CFO) |
| Authorized Official Contact | 2182819756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverview Healthcare Association 323 S Minnesota St Crookston MN 56716-1601 Ph: (218) 281-9200 | Riverview Healthcare Association 1428 Central Ave Ne East Grand Forks MN 56721-1605 Ph: (218) 773-1390 |
| NPI Number | 1811918436 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/22/2019 |
| Medicare PECOS PAC ID | 7810806718 |
|---|---|
| Medicare Enrollment ID | O20040128000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811918436 | NPI | - | NPPES |
| 5548 | Other | ND | BCBS |
| 12898 | Medicaid | ND | |
| 244T9RI | Other | MN | BCBS |
| 973488300 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | David M Schall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932170057 PECOS PAC ID: 7416869805 Enrollment ID: I20031104000339 |
| Provider Name | Colin W Fennell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356313480 PECOS PAC ID: 7517853617 Enrollment ID: I20040225000839 |
| Provider Name | David M Rathbone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154413581 PECOS PAC ID: 5294621306 Enrollment ID: I20040225000874 |
| Provider Name | John W Torseth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437246808 PECOS PAC ID: 3173513207 Enrollment ID: I20040512001177 |
| Provider Name | Erik J Kanten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679593206 PECOS PAC ID: 0840193934 Enrollment ID: I20040630000110 |
| Provider Name | Panjini M Sivanna |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1013948116 PECOS PAC ID: 7315843596 Enrollment ID: I20040708000425 |
| Provider Name | Steven L Poissant |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053367029 PECOS PAC ID: 9032161013 Enrollment ID: I20050217000798 |
| Provider Name | Brett K Vibeto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891721841 PECOS PAC ID: 2769419142 Enrollment ID: I20050719000166 |
| Provider Name | Alicia A Frankwitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720027303 PECOS PAC ID: 9234159450 Enrollment ID: I20051202000518 |
| Provider Name | Mathew L Stayman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548217268 PECOS PAC ID: 0547241531 Enrollment ID: I20060306000729 |
| Provider Name | Andrew L Makowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770514861 PECOS PAC ID: 4385648021 Enrollment ID: I20060911000634 |
| Provider Name | Diane M Palkert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093807786 PECOS PAC ID: 9638166986 Enrollment ID: I20061129000396 |
| Provider Name | Noah N Chelliah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952485740 PECOS PAC ID: 9032166038 Enrollment ID: I20061205000606 |
| Provider Name | Chad Eugene Boen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215034095 PECOS PAC ID: 9133117443 Enrollment ID: I20070205000622 |
| Provider Name | Olatubosun B Fashoro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700823598 PECOS PAC ID: 7517064793 Enrollment ID: I20070523000208 |
| Provider Name | Erika K Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20081202000100 |
| Provider Name | Ram Prasad Paneru |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740457902 PECOS PAC ID: 7719043926 Enrollment ID: I20090312000344 |
| Provider Name | Matthew S Viscito |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497969570 PECOS PAC ID: 9537227079 Enrollment ID: I20090324000554 |
| Provider Name | Bryan S Delage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588636427 PECOS PAC ID: 0547161523 Enrollment ID: I20090327000137 |
| Provider Name | Kari D Wessman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235150574 PECOS PAC ID: 6800948431 Enrollment ID: I20090713000587 |
| Provider Name | Scott A Fontaine |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801956792 PECOS PAC ID: 1759370307 Enrollment ID: I20090924000357 |
| Provider Name | Brenda J King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598799892 PECOS PAC ID: 7517990062 Enrollment ID: I20100127000951 |
| Provider Name | Brent Kaiser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376871475 PECOS PAC ID: 4880723097 Enrollment ID: I20100526001077 |
| Provider Name | Max C Miranda |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225259567 PECOS PAC ID: 6204024219 Enrollment ID: I20101217000094 |
| Provider Name | Sunny S Kim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114989555 PECOS PAC ID: 3971506577 Enrollment ID: I20110113000443 |
| Provider Name | Hamid R Abbasi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1932303526 PECOS PAC ID: 6507937588 Enrollment ID: I20120213000096 |
| Provider Name | Eric B Roed |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932216579 PECOS PAC ID: 8527227909 Enrollment ID: I20120302000597 |
| Provider Name | Jermey J Eversvik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437345295 PECOS PAC ID: 7618062480 Enrollment ID: I20120316000592 |
| Provider Name | Evans O Magambo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881824407 PECOS PAC ID: 3476709825 Enrollment ID: I20120817000319 |
| Provider Name | Nathaniel D Mclean |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033348545 PECOS PAC ID: 1355598319 Enrollment ID: I20120827000134 |
| Provider Name | Christopher P Lindgren |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720222805 PECOS PAC ID: 4486823424 Enrollment ID: I20120928000295 |
| Provider Name | Sara B May |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457377707 PECOS PAC ID: 6901834878 Enrollment ID: I20130708000403 |
| Provider Name | Arveity R Setty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174755615 PECOS PAC ID: 2769623032 Enrollment ID: I20130729000979 |
| Provider Name | Mary K Holm |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477583664 PECOS PAC ID: 0446349153 Enrollment ID: I20131018000413 |
| Provider Name | Natalie R Royal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457636003 PECOS PAC ID: 4688831167 Enrollment ID: I20140414000009 |
| Provider Name | Nathan Spicer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770763062 PECOS PAC ID: 7517055460 Enrollment ID: I20140612001778 |
| Provider Name | Roshan Ghimire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184936072 PECOS PAC ID: 9335391135 Enrollment ID: I20141205000648 |
| Provider Name | Joe E Dib |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700820933 PECOS PAC ID: 6507928512 Enrollment ID: I20141205001258 |
| Provider Name | Rebekah J Aakre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134538911 PECOS PAC ID: 8022237148 Enrollment ID: I20141213000255 |
| Provider Name | Tia M Gullickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992187868 PECOS PAC ID: 0749593804 Enrollment ID: I20150717001787 |
| Provider Name | Vinita J Parikh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780842963 PECOS PAC ID: 0749474096 Enrollment ID: I20160413000732 |
| Provider Name | Casey B Wangen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659820116 PECOS PAC ID: 6204124019 Enrollment ID: I20161011002270 |
| Provider Name | Kari L Gudmundson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083072466 PECOS PAC ID: 2567767387 Enrollment ID: I20161129001535 |
| Provider Name | Abbey Lee Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891215836 PECOS PAC ID: 7719250497 Enrollment ID: I20170830003760 |
| Provider Name | Bethany J Staehnke |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821470907 PECOS PAC ID: 1850646993 Enrollment ID: I20180614000012 |
| Provider Name | Marilyn Rae Geninatti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649204819 PECOS PAC ID: 5991723710 Enrollment ID: I20180719003177 |
| Provider Name | Maneesh C Kanal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700271012 PECOS PAC ID: 6608173158 Enrollment ID: I20180820003618 |
| Provider Name | Eric A Schommer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295179687 PECOS PAC ID: 2062646250 Enrollment ID: I20181105003415 |
| Provider Name | Monica A Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417430588 PECOS PAC ID: 1456695865 Enrollment ID: I20181211002459 |
| Provider Name | Maen Abou-ghaida |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174008288 PECOS PAC ID: 8325387129 Enrollment ID: I20190221002126 |
| Provider Name | Todd D Sekundiak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780634568 PECOS PAC ID: 7719901982 Enrollment ID: I20190408001505 |
| Provider Name | Rebecca A Schulz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881247575 PECOS PAC ID: 0547590721 Enrollment ID: I20191002000073 |
| Provider Name | David Gutman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376507079 PECOS PAC ID: 8921012113 Enrollment ID: I20200611003020 |
| Provider Name | Forrest V Laporte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538786207 PECOS PAC ID: 0941626204 Enrollment ID: I20200817003457 |
| Provider Name | Huy H Nguyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194143693 PECOS PAC ID: 4486959657 Enrollment ID: I20200824000735 |
| Provider Name | Timothy R Schmiedeberg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194919357 PECOS PAC ID: 1850472788 Enrollment ID: I20201203001129 |
| Provider Name | Heather Lynn Waldal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225629777 PECOS PAC ID: 3779990072 Enrollment ID: I20210405000662 |
| Provider Name | Lauren Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366977340 PECOS PAC ID: 2365710175 Enrollment ID: I20210729001002 |
| Provider Name | Ira H Lubkin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548329923 PECOS PAC ID: 6800794744 Enrollment ID: I20210817001870 |
| Provider Name | Erin Jore |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1275953762 PECOS PAC ID: 9537384904 Enrollment ID: I20210922000399 |
| Provider Name | Chinenye Alozie Jude Ochiobi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669965422 PECOS PAC ID: 6800294729 Enrollment ID: I20211007001214 |
| Provider Name | Tina Safranski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871849000 PECOS PAC ID: 0547668287 Enrollment ID: I20211011000056 |
| Provider Name | Maddie Bjornstad |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720560600 PECOS PAC ID: 9931446960 Enrollment ID: I20211019000042 |
| Provider Name | Luke A. Hunter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891145983 PECOS PAC ID: 8527484203 Enrollment ID: I20211130001790 |
| Provider Name | Kessiena Aya-olabisi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588047096 PECOS PAC ID: 7911398896 Enrollment ID: I20220104000770 |
| Provider Name | Riley Hermreck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700533775 PECOS PAC ID: 8224425434 Enrollment ID: I20220418001435 |
| Provider Name | Brittni Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790152296 PECOS PAC ID: 7416355177 Enrollment ID: I20220622001764 |
| Provider Name | Lori Hefta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972711521 PECOS PAC ID: 5496138950 Enrollment ID: I20220816001282 |
| Provider Name | Zackary Fordham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265589089 PECOS PAC ID: 5092897801 Enrollment ID: I20230906003731 |
| Provider Name | Rhonda Lee Breitbach |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770729659 PECOS PAC ID: 9436202587 Enrollment ID: I20230907003729 |
| Provider Name | Lisa Danielle Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609553791 PECOS PAC ID: 5092179648 Enrollment ID: I20230914002321 |
| Provider Name | Eberechi C Ekechukwu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710418074 PECOS PAC ID: 9335489061 Enrollment ID: I20231004001457 |
| Provider Name | Bryan Sleigh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780771782 PECOS PAC ID: 4284859398 Enrollment ID: I20231004002277 |
| Provider Name | Haley Faye Wahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669017265 PECOS PAC ID: 7618398694 Enrollment ID: I20231012003249 |
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Riverview Healthcare Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1428 Central Ave Ne, East Grand Forks, MN 56721 Phone: 866-773-1390 | |
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