Active NPI
Abdirizak Ibrahim
- Driver
- Minneapolis, MN
National Provider Identifier
1144685660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- P1236165405210
- Practice address
- 127 W Lake St
Minneapolis, MN 55408-3141 - Phone
- (952) 649-1046
- NPI assigned
- Dec 28, 2015
- Last updated
- Dec 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | P1236165405210 | MN | Primary |
Addresses
Primary practice location
127 W Lake St
Minneapolis, MN 55408-3141
Mailing address
127 W Lake St
Minneapolis, MN 55408-3141
Phone (952) 649-1046
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1236165405210 | MN | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Care Services | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Golden Valley, MN
- NPI 1639884174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451260800000",
"number": "1144685660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 W LAKE ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554083141",
"telephone_number": "952-649-1046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 W LAKE ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554083141",
"telephone_number": "952-649-1046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "ABDIRIZAK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-28",
"last_updated": "2015-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "MN",
"license": "P1236165405210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.