NPIMap

Organization Active NPI

Shifa Mental Health Services PLLC

  • Psychiatry Physician
  • Eagan, MN
National Provider Identifier
1366877243
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
50545 Issued in MN
Legal business name
SHIFA MENTAL HEALTH SERVICES PLLC
Practice address
2781 Pilot Knob Rd
Eagan, MN 55121-1119
Phone
(651) 289-7300
Fax
(651) 289-7301
NPI assigned
Sep 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Authorized official

Name
Salima Naqvi, M.D
Title
Organizer
Phone
(612) 386-5020

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 50545 MN Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X 50545 MN
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

2781 Pilot Knob Rd
Eagan, MN 55121-1119

Mailing address

3044 170TH St SW
Prior Lake, MN 55372-2334

Other identifiers 3

IdentifierTypeStateIssuer
1912041278MedicaidMN
H100102182OtherMNMDCR PTAN GROUP
H400102209OtherMNMEDICARE PTAN INDIVIDUAL

National Provider Directory

National Provider Directory

Locations

2781 Pilot Knob Rd
Saint Paul, MN 55121
Phone (651) 251-5132

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1366877243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 170TH ST SW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 PILOT KNOB RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211119",
            "telephone_number": "651-289-7300",
            "fax_number": "651-289-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFA MENTAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "NAQVI",
        "authorized_official_first_name": "SALIMA",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "612-386-5020",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "50545",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MN",
            "license": "50545",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912041278",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR PTAN GROUP",
            "identifier": "H100102182",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN INDIVIDUAL",
            "identifier": "H400102209",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.