Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northeast Pediatric Clinic PA

Organization Primary Care Clinic/Center · NPI 1730162371

Northeast Pediatric Clinic PA is a Primary Care Clinic/Center in Vadnais Heights, Minnesota. Registered with an NPI since 2005.

In the registry since
2005
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4520 Centerville Rd
Vadnais Heights, MN 55127-3602
Phone: (651) 426-1141
Fax: (651) 426-1705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1730162371
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Ann Leukuma — Ceo · (651) 426-1141
NPI enumeratedNovember 29, 2005
Last updated in NPPESAugust 22, 2020
Mailing address4520 Centerville Rd, Vadnais Heights, MN 55127-3602

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