Shamala Tamirisa, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5634 Issued in NE

Practice address

9400 Zane Ave N
Brooklyn Park, MN 55443-1814

Phone

(763) 762-8800

Fax

(736) 315-4669

NPI assigned

Mar 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stamirisa192726@excellian.direct.allina.com

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment Care Compare group NPD
• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment NPD
• Allina Health System

  • Physical Medicine & Rehabilitation Physician
  • St Paul, MN
  • NPI 1962659094
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Allina Health System

  • Addiction (Substance Use Disorder) Psychologist
  • Fridley, MN
  • NPI 1083197214

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Cambridge, MN
  • NPI 1215755400
  Care Compare affiliation
• Allina Health System

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Fridley, MN
  • NPI 1285692145
  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1316904287
  Care Compare affiliation
• Allina Health System

  • Radiation Oncology Clinic/Center
  • Buffalo, MN
  • NPI 1417548959

  Hospital

  Care Compare affiliation
• Allina Health System

  • Maternal & Fetal Medicine Physician
  • Coon Rapids, MN
  • NPI 1447527767

  Hospital

  Care Compare affiliation
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1598700528

  Hospital

  Care Compare affiliation
• Allina Health System

  • Psychiatric Hospital Unit
  • Fridley, MN
  • NPI 1609056100
  Care Compare affiliation

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1336311653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "736-315-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMIRISA",
        "first_name": "SHAMALA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "5634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Swenson, APRN, CPNP
• Raeanna Swenson
• Kaitlyn Ann Sylvers, OT
• Adebola Taiwo
• Branko Saah Tambah
• Target
• Target
• Target
• Target Pharmacy
• Albert Goethe Tarpeh

• Psychiatry Physician in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.