Individual provider Active NPI

Fatma Al-Motassem Reda, MD

  • Psychiatry Physician
  • Eden Prairie, MN
National Provider Identifier
1043238934
Registry record updated Jul 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
24164 Issued in MN
Practice address
7800 Bailey Dr
Eden Prairie, MN 55347-1175
Phone
(952) 484-9006
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 24164 MN Primary

Addresses

Primary practice location

7800 Bailey Dr
Eden Prairie, MN 55347-1175

Mailing address

PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Counseling Assessment and Mediation Centers PLLC PastSince Jan 1, 2014 Accepting new patients
Affiliated Counseling Center PastSince Oct 19, 2009 Accepting new patients
Youable Emotional Health Services PastSince Nov 25, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563580800000",
    "number": "1043238934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 BAILEY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471175",
            "telephone_number": "952-484-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDA",
        "first_name": "FATMA",
        "middle_name": "AL-MOTASSEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "24164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.