Active NPI
Waheed Momoh
- Orthopedic Physical Therapist
- Bloomington, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 12236
- Practice address
- 3800 American Blvd W # 200
Bloomington, MN 55431-4420 - Phone
- (952) 831-8742
- NPI assigned
- Jun 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 12236 | MN | Primary |
Addresses
Primary practice location
3800 American Blvd W # 200
Bloomington, MN 55431-4420
Mailing address
1741 Hallmark Ave N
Oakdale, MN 55128-5418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742
3800 American Blvd W
Suite 200
Bloomington, MN 55431-4420
Phone (952) 831-8742
8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tria Orthopaedic Center LLC | Single Specialty | Current | Accepting new patients |
Locations
3800 American Blvd W
#200
Bloomington, MN 55431
8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Bloomington, MN
- NPI 1518273085
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1497322192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1741 HALLMARK AVE N",
"city": "OAKDALE",
"state": "MN",
"postal_code": "551285418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 AMERICAN BLVD W # 200",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314420",
"telephone_number": "952-831-8742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMOH",
"first_name": "WAHEED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-10",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": "MN",
"license": "12236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.