Individual provider Active NPI

Abdirizak Hassan Mohamed, BEHAVIOR TECHNICIAN

  • Behavior Analyst
  • Minneapolis, MN
National Provider Identifier
1265222186
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
B422017382108 Issued in MN
Practice address
2750 Park Ave S
JD@Bmamn.Com
Minneapolis, MN 55407
Phone
(612) 381-6080
Fax
(952) 513-7771
NPI assigned
May 12, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X B422017382108 MN Primary

Addresses

Primary practice location

2750 Park Ave S
JD@Bmamn.Com
Minneapolis, MN 55407

Mailing address

2750 Park Ave S
JD@Bmamn.Com
Minneapolis, MN 55407
Phone (612) 381-6080

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

State licenses

LicenseStateTypeSpecialty
B422017382108MNMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1265222186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 PARK AVE S",
            "address_2": "JD@BMAMN.COM",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-381-6080",
            "fax_number": "952-513-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 PARK AVE S",
            "address_2": "JD@BMAMN.COM",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-381-6080",
            "fax_number": "952-513-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "ABDIRIZAK",
        "middle_name": "HASSAN",
        "credential": "BEHAVIOR TECHNICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "B422017382108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.