My Medical Clinic PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

45908 Issued in MN

Legal business name

MY MEDICAL CLINIC PLLC

Practice address

1560 Beam Ave
Maplewood, MN 55109-1191

Phone

(651) 484-6923

NPI assigned

Jul 16, 2014

Organization subpart

No

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

Authorized official

Name

Chaitanya Anand, MDNPI 1275599136

Title

CMD/Founder and Owner

Phone

(651) 484-6923

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chaitanya Anand, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1275599136
  Medicare reassignment Authorized official
• Alena Nelson, CNP

  • Family Nurse Practitioner
  • Saint Paul, MN
  • NPI 1346691979
  NPD (past)

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1215344742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4872 STEEPLECHASE WAY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222978",
            "telephone_number": "651-484-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091191",
            "telephone_number": "651-484-6923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4130 Blackhawk Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551221700",
            "country_code": "US",
            "telephone_number": "651-484-6923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12805 Hwy 55 Ste 125",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554413861",
            "country_code": "US",
            "telephone_number": "651-340-1445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "ANAND",
        "authorized_official_first_name": "CHAITANYA",
        "authorized_official_title_or_position": "CMD/FOUNDER AND OWNER",
        "authorized_official_telephone_number": "651-484-6923",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": "45908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John D Murray, D.O.
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• Abijah Muthyala, M.D.
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• Baylee Nahan
• Kathleen Nakata
• Sakina B Naqvi, M.D
• Anthony R Nardi, MD

• Multi-Specialty Clinic/Center in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Multi-Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.