Mohamed Abdi Adan
Individual provider Active NPI Physician Assistant · Minneapolis, MN
NPI 1336725837 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1336725837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1801 Nicollet Ave
Minneapolis, MN 55403-3791 - Phone
- (612) 823-2947
- Fax
- (612) 870-2947
- NPI assigned
- Mar 23, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 23
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Commonwealth Medical College, 2021
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Primemed PLLC
Practice addresses (Care Compare)
322 W Lake St
Suite 101
Minneapolis, MN 55408-3025
Phone (857) 492-6395
Hospital & facility affiliations
- Abbott Northwestern Hospital
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230509000904 | MN | Practitioner - Physician Assistant | 0547646531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13901 | MN | MD | Physical Therapist |
Interoperability endpoints
- mohamed.adan.1@29159.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1801 Nicollet Ave
Minneapolis, MN 55403-3791
Mailing address
2300 E Franklin Ave
Minneapolis, MN 55406-1072
Phone (857) 492-6395
Other practice location 1
1 W Lake St
Minneapolis, MN 55408-3154
Phone (612) 823-2947
Other providers in Minneapolis, MN
- Habiibo Adan
- Hamdi Farah Adan
- Hana Mohamed Adan
- Mahad Hussein Adan
- Mahad N Adan
- Sahro Mohamed Adan
- Asha Adani
- Solaman Shire Adani Sr.
- Collin Ray Adank
- Adapthealth Minnesota LLC
All providers in Minneapolis, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.