Individual provider Active NPI

Nissar Vahora

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1407299423
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
64854 Issued in MN
Practice address
2355 Hwy 36 W.
Roseville, MN 55113
Phone
(651) 292-2000
NPI assigned
Apr 9, 2013
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 64854 MN Primary

Addresses

Primary practice location

2355 Hwy 36 W.
Roseville, MN 55113

Mailing address

2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Phone (651) 292-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TX, ND, WI4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20190626001823 MN Practitioner - Diagnostic Radiology 4183864168 Reassigns benefits to 19 organizations
I20200121001113 TX Practitioner - Diagnostic Radiology 4183864168 Reassigns benefits to 6 organizations
I20230719002875 ND Practitioner - Diagnostic Radiology 4183864168 Reassigns benefits to 3 organizations
I20230726003647 WI Practitioner - Diagnostic Radiology 4183864168 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Suburban Imaging LLCGroup PAC ID 4688564867, 142 clinicians

Practice addresses (Care Compare)

Parker, TX 75002
Phone (651) 292-2000

2355 Hwy 36 W
Suite 100
Roseville, MN 55113-3905
Phone (651) 292-2000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

8990 Springbrook Dr NW
Suite 140
Coon Rapids, MN 55433-5880
Phone (763) 792-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD CurrentSince May 21, 2025 Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2023 Accepting new patients
Altru Health System CurrentSince Jul 15, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Park Nicollet Clinic CurrentSince Jul 1, 2023 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Jul 1, 2023 Accepting new patients
Altru Health System CurrentSince Jul 15, 2023 Accepting new patients
Towner County Medical Center Inc CurrentSince Jul 5, 2023 Accepting new patients
Lac Qui Parle Clinic of Madison Inc CurrentSince Jan 3, 2026 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
The Duluth Clinic, LTD. CurrentSince May 21, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Fairview Clinics Current Accepting new patients
Range Regional Health Services CurrentSince Feb 1, 2025 Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2023 Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Pembina County Memorial Hospital Association CurrentSince Jul 5, 2023 Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Allina Health System CurrentSince Jul 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Jul 1, 2023 Accepting new patients
Range Regional Health Services Current Accepting new patients
Fairview Express Care CurrentSince Sep 4, 2019 Accepting new patients
P R Health Corporation Current Accepting new patients
Lutheran Charity Association Diagnostic Radiology CurrentSince Nov 20, 2024 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Range Regional Health Services CurrentSince Feb 1, 2025 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Ridgeview Medical Center Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Sep 4, 2019 Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2023 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Madison Healthcare Services CurrentSince Aug 3, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 15, 2024 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
St. Joseph's Hospital and Health Center Current Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Jul 1, 2019 Accepting new patients

Locations (25 of 39)

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

111 Hundertmark Rd
Ste 130
Chaska, MN 55318
Phone (952) 456-7400

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7556

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2945 Hazelwood St
Ste 110
Maplewood, MN 55109

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

500 Osborne Rd NE
Ste 150
Minneapolis, MN 55432
Phone (763) 236-2500

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

6545 France Ave S
Ste 115
Minneapolis, MN 55435
Phone (952) 893-1997

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

8496 Enterprise Dr S
Mountain Iron, MN 55768
Phone (217) 741-2250

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Organizations & group practices 51

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.

View all 51

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1407299423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W.",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHORA",
        "first_name": "NISSAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "64854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.