NPIMap

Individual provider Active NPI

Marwan M.B. Abu Minshar, M.D.

  • Nephrology Physician
  • Fargo, ND
National Provider Identifier
1093096406
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
14030 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8000
NPI assigned
Aug 30, 2011
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10040884 TX
Nephrology Physician 207RN0300X 4301104727 MI
Nephrology Physician 207RN0300X 14030 ND Primary
Nephrology Physician 207RN0300X 60976 MN

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160816002296 ND Practitioner - Nephrology 5092017087 Reassigns benefits to 1 organization
I20161101000351 MN Practitioner - Nephrology 5092017087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians
Bridges Medical CenterGroup PAC ID 4981659851, shared by 3 NPIs, 22 clinicians

Practice addresses (Care Compare)

1710 Ctr Ave W
Dilworth, MN 56529-1309
Phone (218) 233-3354

201 9TH St W
Ada, MN 56510-1279

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10040884TXMDInternal Medicine Physician
60976MNMDNephrology Physician
14030NDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Jul 1, 2016 Accepting new patients
Innovis Health, LLC CurrentSince Jul 1, 2016 Accepting new patients
St Mary's Regional Health Center CurrentSince Oct 3, 2016 Accepting new patients
Innovis Health LLC Current Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
St Mary's Regional Health Center CurrentSince Oct 3, 2016 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

1710 Center Ave W
Dilworth, MN 56529
Phone (218) 233-3354

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-4222

2430 20th St SW
Jamestown, ND 58401
Phone (701) 253-5300

275 11th St S
Wahpeton, ND 58075
Phone (701) 642-2000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1093096406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABU MINSHAR",
        "first_name": "MARWAN",
        "middle_name": "M.B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10040884",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301104727",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ND",
            "license": "14030",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "60976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.