Active NPI
Ayantu G/Medhin Bekuto
- Foster Care Agency
- Burnsville, MN
National Provider Identifier
1447979844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- License
- 1109755
- Practice address
- 3309 W 132ND St
Burnsville, MN 55337-1878 - Phone
- (651) 431-1892
- NPI assigned
- Aug 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 1109755 | MN | |
| Foster Care Agency | 253J00000X | 1109755 | MN | Primary |
Addresses
Primary practice location
3309 W 132ND St
Burnsville, MN 55337-1878
Mailing address
3309 W 132ND St
Burnsville, MN 55337-1878
Phone (651) 431-1892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1109755 | Other | MN | INDIVIDUAL PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1109755 | MN | MD | Foster Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1447979844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3309 W 132ND ST",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553371878",
"telephone_number": "651-431-1892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3309 W 132ND ST",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553371878",
"telephone_number": "651-431-1892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEKUTO",
"first_name": "AYANTU",
"middle_name": "G/MEDHIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-26",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "MN",
"license": "1109755",
"primary": false
},
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": "MN",
"license": "1109755",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL PROVIDER",
"identifier": "1109755",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.