Individual provider Active NPI

Zadok Nampala

  • Social Worker
  • Minneapolis, MN
National Provider Identifier
1548723364
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
27266 Issued in MN
Practice address
1313 Penn Ave N
Minneapolis, MN 55411-3047
Phone
(612) 543-2614
NPI assigned
Apr 9, 2019
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 27266 MN Primary

Addresses

Primary practice location

1313 Penn Ave N
Minneapolis, MN 55411-3047

Mailing address

1313 Penn Avenue North
Minneapolis, MN 55411-3047
Phone (612) 543-2614

Other identifiers 1

IdentifierTypeStateIssuer
T781992OtherMNCAR SEAT CERTIFICATION LICENSE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310000955 MN Practitioner - Clinical Social Worker 0547676959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Cities Health Center IncGroup PAC ID 5799696621, 12 clinicians

Practice addresses (Care Compare)

409 Dunlap St N
Saint Paul, MN 55104-4201
Phone (651) 290-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27266MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Feb 17, 2021 Accepting new patients
Open Cities Health Center, Inc. Current Accepting new patients
Open Cities Health Center, Inc. CurrentSince Nov 25, 2022 Accepting new patients
Open Cities Health Center, Inc. CurrentSince Nov 25, 2022 Accepting new patients
Yourtime Therapeutic Services Current Accepting new patients
Hennepin County Current Accepting new patients
Hennepin County CurrentSince Feb 17, 2021 Accepting new patients

Locations

1313 Penn Ave N
Minneapolis, MN 55411
Phone (612) 302-4600

409 Dunlap St N
Saint Paul, MN 55104
Phone (651) 290-9200

916 Rice St
Saint Paul, MN 55117
Phone (651) 251-5993

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDHIBD

Organizations & group practices 7

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1548723364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 PENN AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "612-543-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "612-543-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMPALA",
        "first_name": "ZADOK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "27266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAR SEAT CERTIFICATION LICENSE",
            "identifier": "T781992",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.