Organization Active NPI

Breakthrough Therapy Center, LLC

  • Early Intervention Provider Agency
  • Rochester, MN
National Provider Identifier
1053022756
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
BREAKTHROUGH THERAPY CENTER, LLC
Practice address
2720 Superior Dr NW Ste 101
Rochester, MN 55901-1775
Phone
(952) 212-0358
Fax
(612) 326-6160
NPI assigned
Dec 13, 2022
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Hamid Ahmed Mohamed
Title
Ceo/President
Phone
(612) 707-7530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

2720 Superior Dr NW Ste 101
Rochester, MN 55901-1775

Mailing address

2001 Killebrew Dr Ste 112
Bloomington, MN 55425-1871
Phone (952) 212-0358

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL btctherapy@gmail.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Breakthrough Therapy Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2720 Superior Dr NW
Ste 101
Rochester, MN 55901
Phone (507) 208-4007

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1053022756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 KILLEBREW DR STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251871",
            "telephone_number": "952-212-0358",
            "fax_number": "612-326-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUPERIOR DR NW STE 101",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011775",
            "telephone_number": "952-212-0358",
            "fax_number": "612-326-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "HAMID",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "612-707-7530"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "btctherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2720 Superior Dr NW Ste 101",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559011775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.