Individual provider Active NPI

Maryan H Garad, AGNP

  • Gerontology Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1255096384
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2010509 Issued in MN
Practice address
2448 14TH Ave S
Minneapolis, MN 55404-3930
Phone
(612) 987-7707
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2010509 MN Primary

Addresses

Primary practice location

2448 14TH Ave S
Minneapolis, MN 55404-3930

Mailing address

2448 14TH Ave S
Minneapolis, MN 55404-3930
Phone (612) 987-7707

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
I20230908002231 MN Practitioner - Nurse Practitioner 7315323771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1516 E Lake St
Suite 1512
Minneapolis, MN 55407-1740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2010509MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medina Medical Clinic & Urgent Care CurrentSince May 10, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 26, 2023 Accepting new patients

Locations

1516 E Lake St
Ste 1512
Minneapolis, MN 55407
Phone (612) 345-4929

1010 Dale St N
Saint Paul, MN 55117
Phone (612) 482-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1255096384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 14TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043930",
            "telephone_number": "612-987-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 14TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043930",
            "telephone_number": "612-987-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARAD",
        "first_name": "MARYAN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "2010509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.