Abolfazl Kowsari, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6617 Issued in MN

Practice address

9512 Pineview LN N
Maple Grove, MN 55369-7135

Phone

(763) 923-5608

NPI assigned

Jun 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Fazy Kowsari Other name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrated Wound Care Minnesota PLLCGroup PAC ID 2769722511, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

59.96 of 100Reported as group

Quality

79.07

Promoting interoperability

0

Improvement activities

20

Cost

62.47

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

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.

• Integrated Wound Care Minnesota PLLC

  • General Practice Physician
  • Delano, MN
  • NPI 1205390457
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1073172003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9512 PINEVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697135",
            "telephone_number": "763-923-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9512 PINEVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697135",
            "telephone_number": "763-923-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWSARI",
        "first_name": "ABOLFAZL",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAZY",
            "last_name": "KOWSARI",
            "prefix": "MR.",
            "credential": "CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amos Koukou, MSW, LGSW
• Courtney Lynn Kovacs, DPT
• Joshua Kovalik
• Dillan Thomas Kovash, PT, DPT
• Nicole Elizabeth Kowalkowski
• Belle Kramer
• Laura Olivia Kramer, PA-C
• Elizabeth Patricia Kratz, RN, APRN, AGNP
• Molly Kreutter
• Sarath Vasanth Krishnan, M.D.

• Family Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.