Active NPI
Abdirahman Abdinoor
- Behavior Technician
- Spring Lake Park, MN
National Provider Identifier
1174308308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1330 81St Ave NE
Spring Lake Park, MN 55432-2116 - Phone
- (612) 208-2587
- NPI assigned
- Aug 28, 2023
- Last updated
- Nov 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
1330 81St Ave NE
Spring Lake Park, MN 55432-2116
Mailing address
2400 W 66TH St Apt 345
Richfield, MN 55423-2088
Phone (612) 472-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1330 81St Ave NE
Spring Lake Park, MN 55432-2116
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Higher Peaks Development Center LLC | Current | Accepting new patients | |
| Spectrumworks LLC | Current | Accepting new patients |
Locations
1330 81st Ave NE
Spring Lake Park, MN 55432
Phone (612) 208-2587
Organizations & group practices 2
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.
-
- Early Intervention Provider Agency
- Minnetonka, MN
- NPI 1013681931
-
- Behavior Analyst
- Spring Lake Park, MN
- NPI 1144935891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1174308308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 W 66TH ST APT 345",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232088",
"telephone_number": "612-472-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 81ST AVE NE",
"city": "SPRING LAKE PARK",
"state": "MN",
"postal_code": "554322116",
"telephone_number": "612-208-2587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDINOOR",
"first_name": "ABDIRAHMAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-28",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.