Organization Active NPI

Pathway to Recovery LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Minneapolis, MN
National Provider Identifier
1205683570
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
PATHWAY TO RECOVERY LLC
Practice address
900 20TH Ave S
Minneapolis, MN 55404-2212
Phone
(612) 205-1113
NPI assigned
May 3, 2024
Organization subpart
Yes
Parent organization
SAA HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Authorized official

Name
Sadik Ali, MDNPI 1811377229
Title
Medical Director
Phone
(612) 205-1113

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0401X Primary

Addresses

Primary practice location

900 20TH Ave S
Minneapolis, MN 55404-2212

Mailing address

900 20TH Ave S
Minneapolis, MN 55404-2212
Phone (612) 205-1113

Other practice location 1

900 20th Ave S Ste B
Minneapolis, MN 55404-2212
Phone (612) 205-1113

National Provider Directory

National Provider Directory

Locations

900 20th Ave S
Minneapolis, MN 55404
Phone (612) 205-1113

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1205683570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 20TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042212",
            "telephone_number": "612-205-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 20TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042212",
            "telephone_number": "612-205-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 20th Ave S Ste B",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554042212",
            "country_code": "US",
            "telephone_number": "612-205-1113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHWAY TO RECOVERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAA HOLDINGS LLC",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SADIK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "612-205-1113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "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 May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.