Abdirazak Ibrahim Ali, MD

Individual provider Active NPI Family Medicine Physician · Mankato, MN

NPI 1265128706 · NPPES record last updated Aug 20, 2026

Key facts

NPI
1265128706
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
77425 (MN)
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-1811
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230504001300 MN Order and Referring Only - Family Practice
Practitioner - Family Practice
9638534233

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33328 MN
Family Medicine Physician 207Q00000X 77425 MN Yes
Student in an Organized Health Care Education/Training Program 390200000X 33328 MN

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address aali677992@excellian.direct.allina.com
Direct Messaging Address aali1950754@ehrdirect.mayoclinicmsg.org

Other providers in Mankato, MN

All providers in Mankato, MN · Family Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.