Individual provider Active NPI

Munira Maalimisaq, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1467180836
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9577 Issued in MN
Practice address
2001 Blaisdell Ave
Minneapolis, MN 55404-2414
Phone
(952) 993-8000
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2480378 MN
Nurse Practitioner 363L00000X 9577 MN Primary

Addresses

Primary practice location

2001 Blaisdell Ave
Minneapolis, MN 55404-2414

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other practice location 1

2165 White Bear Ave N
Maplewood, MN 55109-2707
Phone (612) 987-4505

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
I20221122002655 MN Practitioner - Nurse Practitioner 0749658714 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspire Change ClinicGroup PAC ID 4688181555, 2 clinicians

Practice addresses (Care Compare)

2015 Chicago Ave
Minneapolis, MN 55404-2813
Phone (612) 987-4505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2480378MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince May 6, 2024 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Oct 17, 2022 Accepting new patients
Inspire Change Clinic CurrentSince Apr 1, 2025 Accepting new patients
Group Health, Inc. CurrentSince Oct 17, 2022 Accepting new patients
Park Nicollet Clinic Current Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

2001 Blaisdell Ave
Minneapolis, MN 55404
Phone (952) 993-8000

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

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2015 Chicago Ave
Minneapolis, MN 55404
Phone (612) 315-2858

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1467180836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLAISDELL AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042414",
            "telephone_number": "952-993-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2165 White Bear Ave N",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551092707",
            "country_code": "US",
            "telephone_number": "612-987-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAALIMISAQ",
        "first_name": "MUNIRA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2480378",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.