NPIMap

Organization Active NPI

Breakthrough Therapy Center, LLC

  • Early Intervention Provider Agency
  • Bloomington, MN
National Provider Identifier
1386258143
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
BREAKTHROUGH THERAPY CENTER, LLC
Practice address
1701 American Blvd E Ste 19
Bloomington, MN 55425-1401
Phone
(952) 212-0358
Fax
(612) 326-6160
NPI assigned
Aug 31, 2020
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Mr. Hamid Ahmed Mohamed
Title
Co-Founder, Ceo
Phone
(612) 707-7530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

1701 American Blvd E Ste 19
Bloomington, MN 55425-1401

Mailing address

2001 Killebrew Dr Ste 112
Bloomington, MN 55425-1871
Phone (952) 212-0358

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@btcentermn.com

National Provider Directory

National Provider Directory
Tax ID family
Breakthrough Therapy Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1701 American Blvd E
Ste 19
Bloomington, MN 55425
Phone (763) 999-5938

6040 Earle Brown Dr
Brooklyn Center, MN 55430
Phone (612) 405-2244

6040 Earle Brown Dr
Ste 300
Brooklyn Center, MN 55430
Phone (612) 707-7530

2833 13th Ave S
Ste 216
Minneapolis, MN 55407

Practitioners & affiliated clinicians

Practitioners 98

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 98

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1386258143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 KILLEBREW DR STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251871",
            "telephone_number": "952-212-0358",
            "fax_number": "612-326-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 AMERICAN BLVD E STE 19",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251401",
            "telephone_number": "952-212-0358",
            "fax_number": "612-326-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "HAMID",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "CO-FOUNDER, CEO",
        "authorized_official_telephone_number": "612-707-7530",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@btcentermn.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "1701 American Blvd E Ste 19",
            "city": "Bloomington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554251401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.