Individual provider Active NPI

Yaria Isabella Bangura

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1235680836
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP4862 Issued in MN
Practice address
5421 Penn Ave N
Minneapolis, MN 55430-2943
Phone
(612) 812-4744
NPI assigned
Oct 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP4862 MN
Family Nurse Practitioner 363LF0000X CNP4862 MN Primary

Addresses

Primary practice location

5421 Penn Ave N
Minneapolis, MN 55430-2943

Mailing address

625 Snelling Ave N
Saint Paul, MN 55104-2878
Phone (651) 363-3111

Other identifiers 1

IdentifierTypeStateIssuer
1235680836MedicaidMN

Other names 1

  • Yaria Isabella Bangura Professional name

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001967 MN Practitioner - Nurse Practitioner 5698053346 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP4862MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Healthcare Services LLC CurrentSince Feb 9, 2025 Accepting new patients
Group Health, Inc. CurrentSince Mar 18, 2019 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Dec 19, 2016 Accepting new patients
Group Health, Inc. CurrentSince Mar 18, 2019 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Sama Healthcare CurrentSince Nov 1, 2018 Accepting new patients
Better Healthcare Services LLC Current Accepting new patients
Hennepin Healthcare System Inc CurrentSince Dec 19, 2016 Accepting new patients

Locations

1654 Diffley Rd
Ste 100
Eagan, MN 55122
Phone (651) 456-8670

2330 Central Ave NE
Minneapolis, MN 55418
Phone (612) 781-1212

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

Interoperability endpoints

  • Direct secure messaging: yaria.bangura.1@27921.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19405/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1235680836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042878",
            "telephone_number": "651-363-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554302943",
            "telephone_number": "612-812-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGURA",
        "first_name": "YARIA",
        "middle_name": "ISABELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP4862",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235680836",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YARIA",
            "last_name": "BANGURA",
            "middle_name": "ISABELLA",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.