Abdikadar Bouraleh

Primary specialty

Secured Medical Transport (VAN)Taxonomy code 343800000X

License

385117 Issued in MN

Practice address

75 Twin Lake Blvd Apt 114
Little Canada, MN 55127-4039

Phone

(207) 440-8021

Fax

(763) 374-8511

NPI assigned

Nov 7, 2024

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": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1447073457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 TWIN LAKE BLVD APT 114",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551274039",
            "telephone_number": "207-440-8021",
            "fax_number": "763-374-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 TWIN LAKE BLVD APT 114",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551274039",
            "telephone_number": "207-440-8021",
            "fax_number": "763-374-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURALEH",
        "first_name": "ABDIKADAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "MN",
            "license": "385117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Bettelyoun, PHARM D.
• Better Living Home Healthcare, Inc
• Kathy Beyer
• Jessica Blaisdell, PT
• Paige Blasing, LPCC, LADC
• Taylor Jane Brunn
• Labibah Mazen Buraik, MSW, LGSW
• Anthony Martin Butler, LMSW
• Vishal Chandra
• Karston John Chara, MA

• Secured Medical Transport (VAN) in Little Canada, MN
• Providers in Little Canada, MN by specialty
• Secured Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.