Individual provider Active NPI

Ikran Mohmaed Abdi

  • Behavior Technician
  • Eagan, MN
National Provider Identifier
1063374841
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4635 Nicols Rd # 104
Eagan, MN 55122-3337
Phone
(651) 900-2210
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Behavioral Specialists CurrentSince Dec 7, 2025 Accepting new patients

Locations

4635 Nicols Rd
Ste 104
Saint Paul, MN 55122
Phone (612) 289-6480

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

4635 Nicols Rd # 104
Eagan, MN 55122-3337

Mailing address

4635 Nicols Rd # 104
Eagan, MN 55122-3337
Phone (651) 900-2210

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2025.

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1063374841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 NICOLS RD # 104",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223337",
            "telephone_number": "651-900-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 NICOLS RD # 104",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223337",
            "telephone_number": "651-900-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDI",
        "first_name": "IKRAN",
        "middle_name": "MOHMAED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.