Individual provider Active NPI

Nancy M a Fahim, MD

  • Neonatal-Perinatal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1023034329
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
51486 Issued in MN
Practice address
720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone
(612) 884-0649
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 2004035455 MO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 2004035455 MO
Neonatal-Perinatal Medicine Physician 2080N0001X 51486 MN Primary

Addresses

Primary practice location

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414

Mailing address

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone (612) 884-0649

Other identifiers 1

IdentifierTypeStateIssuer
206231201MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000716 MN Practitioner - Pediatric Medicine 1052333556 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51486MNMDNeonatal-Perinatal Medicine Physician
2004035455MOMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Aug 12, 2024 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 11, 2020 Accepting new patients
Childrens Health Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Childrens Health Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Dec 28, 2009 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Dec 11, 2020 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast St. John'S Hospital CurrentSince Dec 11, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 31, 2011 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Dec 28, 2009 Accepting new patients
Fairview Express Care Current Accepting new patients
Childrens Health Care CurrentSince Jan 1, 2019 Accepting new patients

Locations

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: nfahim191302@fairview.direct-ci.com

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1023034329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "NANCY",
        "middle_name": "M A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2004035455",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "2004035455",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "51486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206231201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.