Individual provider Active NPI

Zehra Ansari, M.A.,L.P.

  • Psychologist
  • Maplewood, MN
National Provider Identifier
1336237114
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP1389 Issued in MN
Practice address
2383 Standridge Ave
Maplewood, MN 55109-1545
Phone
(651) 770-3353
Fax
(651) 704-0676
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP1389 MN Primary

Addresses

Primary practice location

2383 Standridge Ave
Maplewood, MN 55109-1545

Mailing address

2383 Standridge Ave
Maplewood, MN 55109-1545
Phone (651) 770-3353

Other identifiers 5

IdentifierTypeStateIssuer
6257994OtherMNMEDICA/UBH
HP21888OtherMNHEALTHPARTNERS
104189OtherMNUCARE MN
30128-02OtherMNPREFERREDONE/BHP
57330ANOtherMNBCBS OF MN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240822002850 MN Practitioner - Clinical Psychologist 8628393097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminous Mind IncGroup PAC ID 3678816402, 9 clinicians

Practice addresses (Care Compare)

1611 County Rd B W
Suite 202
Roseville, MN 55113-4053
Phone (651) 300-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP1389MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Luminous Mind Inc Psychologist CurrentSince Jul 30, 2024 Accepting new patients

Locations

1611 County Road B W
Ste 202
Saint Paul, MN 55113
Phone (651) 300-1112

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, 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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336237114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2383 STANDRIDGE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091545",
            "telephone_number": "651-770-3353",
            "fax_number": "651-704-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2383 STANDRIDGE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091545",
            "telephone_number": "651-770-3353",
            "fax_number": "651-704-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "ZEHRA",
        "credential": "M.A.,L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA/UBH",
            "identifier": "6257994",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP21888",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "104189",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE/BHP",
            "identifier": "30128-02",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "57330AN",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.