Individual provider Active NPI

Ahmed Ali Mussa

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Minneapolis, MN
National Provider Identifier
1316543465
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
124958 Issued in MN
Practice address
2740 Minnehaha Ave # 130-32
Minneapolis, MN 55406-1542
Phone
(612) 814-3271
Fax
(612) 339-5218
NPI assigned
Dec 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 124958 MN Primary

Addresses

Primary practice location

2740 Minnehaha Ave # 130-32
Minneapolis, MN 55406-1542

Mailing address

2740 Minnehaha Ave # 130-32
Minneapolis, MN 55406-1542
Phone (612) 814-3271

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
124958MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Robbinsdale Pharmacy Inc CurrentSince Oct 9, 2022 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1316543465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 MINNEHAHA AVE # 130-32",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061542",
            "telephone_number": "612-814-3271",
            "fax_number": "612-339-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 MINNEHAHA AVE # 130-32",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061542",
            "telephone_number": "612-814-3271",
            "fax_number": "612-339-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSA",
        "first_name": "AHMED",
        "middle_name": "ALI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "124958",
            "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 Dec 4, 2020; 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.