Individual provider Active NPI

Michaelina Afi Bamah, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rogers, MN
National Provider Identifier
1396357786
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7827 Issued in MN
Practice address
12817 Main St
Rogers, MN 55374-9474
Phone
(612) 488-6601
Fax
(612) 488-6402
NPI assigned
Aug 18, 2020
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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 7827 MN Primary

Addresses

Primary practice location

12817 Main St
Rogers, MN 55374-9474

Mailing address

21897 S Diamond Lake Rd
Rogers, MN 55374-4642
Phone (612) 488-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210205000863 MN Practitioner - Nurse Practitioner 9436561834 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11670 Fountains Dr
Suite 200
Maple Grove, MN 55369-7195
Phone (612) 488-6601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7827MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Sujit R Varma Inc CurrentSince Jan 1, 2021 Accepting new patients
Btwins Mental Health PSC CurrentSince Sep 10, 2024 Accepting new patients
Advanced Brain and Body Clinic PLLC CurrentSince Apr 20, 2022 Accepting new patients

Locations

11670 Fountains Dr N
Ste 200
Maple Grove, MN 55369
Phone (612) 355-0693

4444 W 76th St
Ste 400
Minneapolis, MN 55435
Phone (612) 746-7347

13911 Ridgedale Dr
Ste 110
Minnetonka, MN 55305
Phone (605) 348-8000

12817 Main St
Rogers, MN 55374
Phone (612) 488-6601

21897 S Diamond Lake Rd
Ste 400
Rogers, MN 55374

636 Saint Anne St
Rapid City, SD 57701
Phone (605) 348-8000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21285/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1396357786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21897 S DIAMOND LAKE RD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744642",
            "telephone_number": "612-488-6601",
            "fax_number": "612-488-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12817 MAIN ST",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553749474",
            "telephone_number": "612-488-6601",
            "fax_number": "612-488-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMAH",
        "first_name": "MICHAELINA",
        "middle_name": "AFI",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "7827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.