Individual provider Active NPI

Maryan Ahmed Yusuf

  • In Home Supportive Care Agency
  • Fridley, MN
National Provider Identifier
1053129858
Registry record updated Dec 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
5700 Washington St NE
Fridley, MN 55432-5666
Phone
(612) 245-1855
NPI assigned
Dec 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

5700 Washington St NE
Fridley, MN 55432-5666

Mailing address

5700 Washington St NE
Fridley, MN 55432-5666
Phone (612) 245-1855

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1735084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735084800000",
    "number": "1053129858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 WASHINGTON ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325666",
            "telephone_number": "612-245-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 WASHINGTON ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325666",
            "telephone_number": "612-245-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUF",
        "first_name": "MARYAN",
        "middle_name": "AHMED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-25",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.