Abdirisaq Yusuf Mohamed

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

H13989145 Issued in NE

Practice address

1503 N 104TH PLZ
Omaha, NE 68114-1103

Phone

(531) 772-1207

NPI assigned

May 1, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1386433803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 N 104TH PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141103",
            "telephone_number": "531-772-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 N 104TH PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141103",
            "telephone_number": "531-772-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "ABDIRISAQ",
        "middle_name": "YUSUF",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NE",
            "license": "H13989145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Moghadam
• Tay Moh
• Rouaa Mohamad Ali
• Zeinab A Mohamed Kheir
• Abdalla Bakhit Mohamed
• Adnan Hirsi Mohamed
• Ahmed Mohamed
• Alwiya Mohamed
• Amel Hassan Zakkaria Mohamed
• Amina Mohamed

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Omaha, NE
• Providers in Omaha, NE by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.