Mark K Thalacker (NPI# 1063483493, PAC ID# 3678660776) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1063483493 |
| PAC ID by PECOS | 3678660776 |
| Professional Enrollment ID | I20071107000061 |
| Full Name | Mark K Thalacker |
| Organization Legal Name | HEALTHEAST MEDICAL RESEARCH INSTITUTE |
| Address |
1575 Beam Ave Maplewood MN 55109-1126 |
| Phone Number | 6512327000 |
| Gender | M |
| Graduation Year | 1994 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3971407636 |
| Number of Group Practice Members | 491 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240213 | HEALTHEAST WOODWINDS HOSPITAL |
| 240063 | ST JOSEPH'S HOSPITAL |
| 240210 | HEALTHEAST ST JOHN'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1575 Beam Ave, Maplewood, MN 55109-1126 | 6512327000 | HEALTHEAST MEDICAL RESEARCH INSTITUTE |
| 1925 Woodwinds Dr, Woodbury, MN 55125-4445 | 6512320395 | HEALTHEAST MEDICAL RESEARCH INSTITUTE |
| Organization Legal Name | HEALTHEAST MEDICAL RESEARCH INSTITUTE |
| Physicians | 507 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sara Elizabeth Jennerjohn | Certified Nurse Midwife (cnm) | Healtheast Medical Research Institute | 2680 N Snelling Ave, Suite 200, Roseville, MN 55113-1876 |
| Admatha Muthyala Winfred | Hospitalist | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Soua Vang | Physician Assistant | Healtheast Medical Research Institute | 1983 Sloan Pl, Suite 1, Saint Paul, MN 55117-2095 |
| Abby Jean Mohr | Physician Assistant | Healtheast Medical Research Institute | 1700 University Ave W, Saint Paul, MN 55104-3727 |
| Elizabeth R Lehner | Pediatric Medicine | Healtheast Medical Research Institute | 9900 Tamarack Rd, Woodbury, MN 55125-3609 |
| Heather Bacon | Certified Nurse Midwife | Healtheast Medical Research Institute | 3100 Kennard St, Suite 100, Maplewood, MN 55109-4569 |
| Erica Bowen | Family Medicine | Healtheast Medical Research Institute | 14688 Everton Ave, Suite 101, Hugo, MN 55038-6051 |
| Michael E Fried | Clinical Social Worker | Healtheast Medical Research Institute | 1055 Centerville Cir, Vadnais Heights, MN 55127-5033 |
| Sarah K Hallman | Certified Nurse Midwife (cnm) | Healtheast Medical Research Institute | 1925 Woodwinds Dr, Woodbury, MN 55125-4445 |
| Thomas W Brink | Internal Medicine | Healtheast Medical Research Institute | 17 W Exchange St, Suite 835, Saint Paul, MN 55102-1226 |
| Street Address |
1575 BEAM AVE |
| City | MAPLEWOOD |
| State | MN |
| Zip | 55109-1126 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Admatha Muthyala Winfred | Hospitalist | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Kathryn Kempe O'morchoe | Physician Assistant | Minnesota Gastroenterology Pa | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Lori A Fisher | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Rahul Koranne | Internal Medicine | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Ryan H Ban | Hospitalist | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Khin N Aung | Hospitalist | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Justine M Lindgren | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Stephanie M Donnelly | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Molly K Herseth | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Joseph Yeuk Lung Lee | Nephrology | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard A Blackburn | Psychologist, Clinical | Group Health Plan Inc | 2688 Maplewood Dr, Maplewood, MN 55109-1021 |
| James P Davig | Psychologist, Clinical | Group Health Plan Inc | 2688 Maplewood Dr, Maplewood, MN 55109-1021 |
| Jane C Dever | Psychiatry | Group Health Plan Inc | 2688 Maplewood Dr, Maplewood, MN 55109-1021 |
| David H Hess | Optometry | 1431 Beam Ave, Maplewood, MN 55109-1064 | |
| Elizabeth Hauser Cameron | Radiation Oncology | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Seng-chee Lee | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Sima Kavand | Internal Medicine | Healtheast Medical Research Institute | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Marilyn A Harder | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Jeanine M Edstrom | Physician Assistant | Minnesota Gastroenterology Pa | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Mallory Ann Lukan | Certified Registered Nurse Anesthetist (crna) | Metropolitan Anesthesia Network LLP | 1575 Beam Ave, Maplewood, MN 55109-1126 |
| Find all physicians in zip 55109 | |||
| City | MAPLEWOOD |
| Zip Code | 55109 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MAPLEWOOD + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mark K Thalacker.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.