Active NPI
Ebrahim Versi, M.D.
- Gynecologic Oncology Physician
- Eden Prairie, MN
National Provider Identifier
1184732406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- 81853
- Practice address
- 6585 City West Pkwy
Eden Prairie, MN 55344-3248 - Phone
- (908) 698-2390
- NPI assigned
- Aug 27, 2006
- 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 |
|---|---|---|---|---|
| Gynecologic Oncology Physician | 207VX0201X | 81853 | MA | Primary |
Addresses
Primary practice location
6585 City West Pkwy
Eden Prairie, MN 55344-3248
Mailing address
11 Sheephill Dr
Gladstone, NJ 07934-2131
Phone (908) 698-2390
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81853 | MA | MD | Gynecologic Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184732406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SHEEPHILL DR",
"city": "GLADSTONE",
"state": "NJ",
"postal_code": "079342131",
"telephone_number": "908-698-2390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6585 CITY WEST PKWY",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443248",
"telephone_number": "908-698-2390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERSI",
"first_name": "EBRAHIM",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "MA",
"license": "81853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.