Individual provider Active NPI

Fardows Omar Salim, M.D.

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1114344587
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125065806 Issued in IL
Practice address
3033 Excelsior Blvd Ste 275
Minneapolis, MN 55416-5149
Phone
(612) 827-4751
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 125065806 IL Primary

Addresses

Primary practice location

3033 Excelsior Blvd Ste 275
Minneapolis, MN 55416-5149

Mailing address

3033 Excelsior Blvd Ste 275
Minneapolis, MN 55416-5149

Other practice location 1

6545 France Ave S
Edina, MN 55435-2131
Phone (000) 000-0000

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824001375 MN Practitioner - Family Practice 4183926116 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

3033 Excelsior Blvd
Suite 275
Minneapolis, MN 55416-5149
Phone (612) 827-4751

Hospital & facility affiliations

  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125065806ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 3, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Sep 3, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 3, 2019 Accepting new patients
Fairview Clinics CurrentSince Aug 11, 2017 Accepting new patients
Fairview Express Care CurrentSince Sep 3, 2019 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Minneapolis, MN 55435
Phone (952) 848-5600

3033 Excelsior Blvd
Ste 275
Minneapolis, MN 55416
Phone (612) 827-4751

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

5366 386th St NE
North Branch, MN 55056
Phone (651) 674-6800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: fsalim409127@fairview.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1114344587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 275",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 275",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165149",
            "telephone_number": "612-827-4751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6545 France Ave S",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352131",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALIM",
        "first_name": "FARDOWS",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125065806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.