Individual provider Active NPI

Mansur Ahmad

  • Oral and Maxillofacial Radiology Dentistry
  • Minneapolis, MN
National Provider Identifier
1235281502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
FF3 Issued in MN
Practice address
515 Delaware St SE
Minneapolis, MN 55455-0357
Phone
(612) 626-5844
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X FF3 MN Primary

Addresses

Primary practice location

515 Delaware St SE
Minneapolis, MN 55455-0357

Mailing address

14382 Bayberry CT
Rosemount, MN 55068-4479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000101 MN Practitioner - Oral SurgeryPractitioner - Other (Physician) 7012967680

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

515 Delaware Ave SE
7 530 Floor Moos Tower
Minneapolis, MN 55455-0348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota CurrentSince Mar 16, 2010 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Mar 16, 2010 Accepting new patients

Locations

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235281502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14382 BAYBERRY CT",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550357",
            "telephone_number": "612-626-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "MANSUR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "MN",
            "license": "FF3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.