Bryan Mohr, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

631 Issued in MN

Practice address

6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673

Phone

(612) 788-8778

Fax

(612) 869-3473

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Feet, Foot and Ankle Health CenterGroup PAC ID 1254401300, 18 clinicians

In House Senior Services LLCGroup PAC ID 7113170267, 16 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Active Feet , Foot & Ankle Health Center

  • Primary Podiatric Medicine Podiatrist
  • Minneapolis, MN
  • NPI 1689848392

  MN, Podiatrist

  Medicare reassignment Care Compare group NPD Authorized official
• In House Senior Services, LLC

  • Primary Podiatric Medicine Podiatrist
  • Richfield, MN
  • NPI 1083962294

  MN, Podiatrist, WI

  Medicare reassignment Care Compare group NPD
• Mille Lacs Health System

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699

  MN

  Medicare reassignment NPD
• Active Feet, Foot & Ankle Health Center

  • Foot & Ankle Surgery Podiatrist
  • Minneapolis, MN
  • NPI 1164716387
  NPD Authorized official
• Maplewood Podiatry, LLC

  • Podiatrist
  • Maplewood, MN
  • NPI 1023069259
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1043215528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 105",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232673",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1164-25",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "54B22MO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP30542",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "124307",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148473700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamed Ali Mohamed
• Sameeha Mohamed
• Amal Mohamed Mohamoud
• Faaiso Ahmed Mohamud
• Habsa Hassan Mohamud
• Patrick W Moody
• Pamela D Moon
• Nicolas William Morgan-Sivongsay
• Frank Edward Mork III, DDS
• Jaime Merlin Morlock

• All providers in Richfield, MN
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.