Individual provider Active NPI

Anisaa Husein Ali

  • Physician Assistant
  • Saint Cloud, MN
National Provider Identifier
1477238194
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15319 Issued in MN
Practice address
3405 3Rd St N
Saint Cloud, MN 56303-4015
Phone
(315) 395-0766
NPI assigned
Jun 20, 2023
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15319 MN Primary

Addresses

Primary practice location

3405 3Rd St N
Saint Cloud, MN 56303-4015

Mailing address

2392 Valley View Rd
Shakopee, MN 55379-9419
Phone (315) 395-0766

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
I20250715002834 MN Practitioner - Physician Assistant 1456866797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hayat Clinic PLLCGroup PAC ID 4183063175, 4 clinicians

Practice addresses (Care Compare)

3405 3Rd St N
Saint Cloud, MN 56303-4015
Phone (320) 774-1041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15319MNMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: anisaa.ali.1@31517.direct.athenahealth.com

Organizations & group practices 1

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1477238194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2392 VALLEY VIEW RD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553799419",
            "telephone_number": "315-395-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 3RD ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034015",
            "telephone_number": "315-395-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSEIN ALI",
        "first_name": "ANISAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.