NPIMap

Organization Active NPI

Benevolence LLC

  • Early Intervention Provider Agency
  • Rochester, MN
National Provider Identifier
1184367146
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
BENEVOLENCE LLC
Practice address
18 Woodlake Dr SE
Rochester, MN 55904-6250
Phone
(507) 517-9142
NPI assigned
Apr 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Mr. Mohamud AhmedNPI 1225747512
Title
Ceo
Phone
(507) 517-9142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Early Intervention Provider Agency 252Y00000X Primary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

18 Woodlake Dr SE
Rochester, MN 55904-6250

Mailing address

18 Woodlake Dr SE
Rochester, MN 55904-6250
Phone (507) 517-9142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221128001300 MN Part B Supplier - Clinic/Group Practice 0547638447 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

18 Woodlake Dr SE
Rochester, MN 55904
Phone (612) 202-6124

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1184367146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046250",
            "telephone_number": "507-517-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046250",
            "telephone_number": "507-517-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEVOLENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MOHAMUD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-517-9142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.