Individual provider Active NPI

Risquat Betara-Aliyu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1366208787
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R244318 Issued in MD
Practice address
100 Washington Ave S Ste 900
Minneapolis, MN 55401-2455
Phone
(888) 477-9648
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R244318 MD Primary

Addresses

Primary practice location

100 Washington Ave S Ste 900
Minneapolis, MN 55401-2455

Mailing address

10821 Red Run Blvd Unit 1682
Owings Mills, MD 21117-8577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805003116 MD Practitioner - Nurse Practitioner 8224575550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R244318MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Resonance Behavioral Health Services Psychiatric/Mental Health CurrentSince Jun 22, 2024 Accepting new patients
Bright Care Solutions LLC CurrentSince Oct 1, 2024 Accepting new patients
Beth Psychiatry LLC Psychiatric/Mental Health Past Accepting new patients

Locations

5602 Baltimore National Pike
Ste 507
Catonsville, MD 21228
Phone (443) 583-8707

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1366208787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10821 RED RUN BLVD UNIT 1682",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211178577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON AVE S STE 900",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012455",
            "telephone_number": "888-477-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETARA-ALIYU",
        "first_name": "RISQUAT",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R244318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.