Individual provider Active NPI

Benjamin Al-Haddad, MD, MSC, PHD

  • Neonatal-Perinatal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1174917322
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
71775 Issued in MN
Practice address
2450 Riverside Ave # Ao-401
Minneapolis, MN 55454-1450
Phone
(612) 626-0644
NPI assigned
Mar 25, 2015
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 71775 MN
Pediatrics Physician 208000000X MD60868947 WA
Neonatal-Perinatal Medicine Physician 2080N0001X 71775 MN Primary

Addresses

Primary practice location

2450 Riverside Ave # Ao-401
Minneapolis, MN 55454-1450

Mailing address

2450 Riverside Ave # Ao-401
Minneapolis, MN 55454-1450

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
I20220817002313 MN Practitioner - Pediatric Medicine 3375864218 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60868947WAMDPediatrics Physician
71775MNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Sep 30, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Nov 28, 2024 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Nov 28, 2024 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Sep 30, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Sep 30, 2022 Accepting new patients
Fairview Express Care CurrentSince Sep 30, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Sep 30, 2022 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

2450 Riverside Ave
#401
Minneapolis, MN 55454
Phone (612) 626-0644

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

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

Interoperability endpoints

  • Direct secure messaging: balhaddad742203@fairview.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1174917322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE # AO-401",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE # AO-401",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-626-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HADDAD",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "71775",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60868947",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "71775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.