Individual provider Active NPI

Fardowsa Bedel Hassan, BAS

  • Behavior Technician
  • Eagan, MN
National Provider Identifier
1225836745
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2110 Silver Bell Road
Eagan, MN 55122-1024
Phone
(952) 767-4200
Fax
(952) 767-4211
NPI assigned
Mar 3, 2025
Sex
Female
Sole proprietor
No

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

2110 Silver Bell Road
Eagan, MN 55122-1024

Mailing address

5860 Baker Rd
Minnetonka, MN 55345-5903
Phone (952) 767-4200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2025.

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1225836745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 BAKER RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455903",
            "telephone_number": "952-767-4200",
            "fax_number": "952-767-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 SILVER BELL ROAD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221024",
            "telephone_number": "952-767-4200",
            "fax_number": "952-767-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "FARDOWSA",
        "middle_name": "BEDEL",
        "credential": "BAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.