Active NPI
Nastaho Mohamed Ali
- Behavior Analyst
- Shakopee, MN
National Provider Identifier
1245944933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1360 Stagecoach Rd Unit 423
Shakopee, MN 55379-8064 - Phone
- (507) 530-7077
- NPI assigned
- Jan 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1360 Stagecoach Rd Unit 423
Shakopee, MN 55379-8064
Mailing address
145 Hamel Rd
Medina, MN 55340-9535
Phone (612) 756-9107
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000 | Other | MN | N/A |
Organizations & group practices 1
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.
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blossompath LLC | Behavior Analyst | Current | Accepting new patients |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1245944933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 HAMEL RD",
"city": "MEDINA",
"state": "MN",
"postal_code": "553409535",
"telephone_number": "612-756-9107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 STAGECOACH RD UNIT 423",
"city": "SHAKOPEE",
"state": "MN",
"postal_code": "553798064",
"telephone_number": "507-530-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALI",
"first_name": "NASTAHO",
"middle_name": "MOHAMED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-09",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "0000000000",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.