Minnehaha Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MINNEHAHA MEDICAL LLC

Practice address

962 University Ave W Ste 3
Saint Paul, MN 55104-4703

Phone

(651) 666-3972

NPI assigned

Dec 13, 2022

Last updated

Jul 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Faysal Warsame

Title

Director

Phone

(763) 332-6293

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1508578238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 UNIVERSITY AVE W STE 3",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044703",
            "telephone_number": "651-666-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 UNIVERSITY AVE W STE 3",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044703",
            "telephone_number": "651-666-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNEHAHA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "WARSAME",
        "authorized_official_first_name": "FAYSAL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "763-332-6293"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.

Verify at the official NPI Registry.