Organization Active NPI

Hayat Clinic PLLC

  • Clinic/Center
  • Saint Cloud, MN
National Provider Identifier
1083489272
Registry record updated Apr 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HAYAT CLINIC PLLC
Practice address
3405 3Rd St N
Saint Cloud, MN 56303-4015
Phone
(320) 774-1041
Fax
(320) 774-1049
NPI assigned
Nov 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2025

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

Authorized official

Name
Dr. Bashir Moallin, MDNPI 1144840463
Title
Owner
Phone
(320) 774-1041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3405 3Rd St N
Saint Cloud, MN 56303-4015

Mailing address

3405 3Rd St N
Saint Cloud, MN 56303-4015
Phone (320) 774-1041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240424000983 MN Part B Supplier - Clinic/Group Practice 4183063175 Receives reassigned benefits from 6 practitioners
Practice locations: Saint Cloud, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2307855Hayat Clinic PLLC3405 3Rd St N, Saint Cloud, MN 56303Certificate of waiverJul 15, 2026

National Provider Directory

National Provider Directory

Locations

3405 3rd St N
Saint Cloud, MN 56303
Phone (320) 253-0567

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743897600000",
    "number": "1083489272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 3RD ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034015",
            "telephone_number": "320-774-1041",
            "fax_number": "320-774-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 3RD ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034015",
            "telephone_number": "320-774-1041",
            "fax_number": "320-774-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYAT CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2025-04-06",
        "certification_date": "2025-04-06",
        "status": "A",
        "authorized_official_last_name": "MOALLIN",
        "authorized_official_first_name": "BASHIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-774-1041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.