NPIMap

Organization Active NPI

Sama Healthcare

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1376906388
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20943 Issued in MN
Legal business name
SAMA HEALTHCARE
Practice address
2639 Nicollet Ave.,
Suite 130
Minneapolis, MN 55408
Phone
(612) 886-2686
Fax
(612) 781-5251
NPI assigned
Mar 29, 2016
Last updated
Apr 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Ms. Suad Haji
Title
Owner
Phone
(612) 987-1439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20943 MN Primary

Addresses

Primary practice location

2639 Nicollet Ave.,
Suite 130
Minneapolis, MN 55408

Mailing address

2639 Nicollet Ave.,
Suite 130
Minneapolis, MN 55408
Phone (612) 886-2686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161207002031 MN Part B Supplier - Clinic/Group Practice 0143500272 Receives reassigned benefits from 8 practitioners
Practice locations: Minneapolis, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2175242Sama Healthcare2639 Nicollet Ave, Suite 130, Minneapolis, MN 55408Certificate of waiverNov 18, 2027

National Provider Directory

National Provider Directory

Locations

2639 Nicollet Ave
Ste 130
Minneapolis, MN 55408
Phone (612) 886-2686

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19405/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1376906388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 NICOLLET AVE.,",
            "address_2": "SUITE 130",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55408",
            "telephone_number": "612-886-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 NICOLLET AVE.,",
            "address_2": "SUITE 130",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55408",
            "telephone_number": "612-886-2686",
            "fax_number": "612-781-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "HAJI",
        "authorized_official_first_name": "SUAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-987-1439",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "20943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.