Active NPI
Ebtihal Ahmed Mohamed Ahmed, MBBS
- Pediatrics Physician
- Mankato, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 75936
- Practice address
- 1025 Marsh St
Mankato, MN 56001-4752 - Phone
- (507) 625-4031
- NPI assigned
- Jul 29, 2017
- Last updated
- Jul 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 4301516547 | MI | |
| Pediatrics Physician | 208000000X | 103129 | WI | |
| Pediatrics Physician | 208000000X | 75936 | MN | Primary |
| Pediatrics Physician | 208000000X | 2020-00654 | NC |
Addresses
Primary practice location
1025 Marsh St
Mankato, MN 56001-4752
Mailing address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4717
Other practice location 1
700 West Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940
Other practice location 2
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4717
Other practice location 3
566 Ruin Creek Rd
Henderson, NC 27536-5932
Phone (252) 438-4143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Minneapolis, MN 55486
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75936 | MN | MD | Pediatrics Physician |
| 2020-00654 | NC | MD | Pediatrics Physician |
| 103129 | WI | MD | Pediatrics Physician |
| 4301516547 | MI | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Maria Parham Physician Practices, LLC | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| DLP Maria Parham Physician Practices LLC | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current | Accepting new patients | |
| DLP Maria Parham Physician Practices, LLC | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Past | Accepting new patients |
Locations
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773
511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440
566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1148
700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156
800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mayo Clinic Health System - Mankato
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
dba Maria Parham Primary Care
- Family Medicine Physician
- Henderson, NC
- NPI 1215273628
-
dba Mayo Clinic Health System - La Crosse
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1629056049
-
dba Mayo Clinic Health System-New Prague
- Multi-Specialty Clinic/Center
- New Prague, MN
- NPI 1477089407
-
dba Mayo Clinic Health System-Waseca
- Multi-Specialty Clinic/Center
- Waseca, MN
- NPI 1518494251
-
- Rural Health Clinic/Center
- Henderson, NC
- NPI 1578256749
-
dba Maria Parham Primary Care
- Family Medicine Physician
- Henderson, NC
- NPI 1720364649
-
dba Mayo Clinic Health System - La Crosse
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1942980917
-
dba Mayo Clinic Health System - Mankato
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1235653452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-625-4031"
}
],
"practiceLocations": [
{
"address_1": "700 West Ave S",
"address_purpose": "LOCATION",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546018806",
"country_code": "US",
"telephone_number": "608-785-0940",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 E Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481095000",
"country_code": "US",
"telephone_number": "734-936-4717",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "566 Ruin Creek Rd",
"address_purpose": "LOCATION",
"city": "Henderson",
"state": "NC",
"postal_code": "275365932",
"country_code": "US",
"telephone_number": "252-438-4143",
"fax_number": "303-343-4756",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AHMED",
"first_name": "EBTIHAL",
"middle_name": "AHMED MOHAMED",
"credential": "MBBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-29",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "MI",
"license": "4301516547",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "103129",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "75936",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2020-00654",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.