NPIMap

Individual provider Active NPI

Mohammad Tariq Fareed, M.D.

  • Family Medicine Physician
  • Plymouth, MN
National Provider Identifier
1598839250
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47197 Issued in MN
Practice address
3455 Plymouth Blvd
Suite#: 200
Plymouth, MN 55447-5544
Phone
(763) 657-1044
Fax
(952) 295-0676
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47197 MN Primary

Addresses

Primary practice location

3455 Plymouth Blvd
Suite#: 200
Plymouth, MN 55447-5544

Mailing address

3455 Plymouth Blvd Ste 200
Plymouth, MN 55447-1551
Phone (763) 657-1044

Other practice location 1

11670 Fountain Drive
Arbor Lakes-Regus Suite
Maple Grove, MN 55369
Phone (763) 657-1044

Other practice location 2

265 Creek Ln S
Jordan, MN 55352-1214
Phone (952) 428-1200

Other identifiers 1

IdentifierTypeStateIssuer
423978400MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfareed602210@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000088 MN Practitioner - Family Practice 5698700144 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779

3455 Plymouth Blvd
Suite 202
Plymouth, MN 55447-1540
Phone (763) 657-1044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine CurrentSince Dec 5, 2014 Accepting new patients
St. Francis Regional Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Allina Health System CurrentSince Sep 16, 2024 Accepting new patients
Allina Health System CurrentSince Sep 16, 2024 Accepting new patients
Fareed Clinic, PLLC CurrentSince Nov 16, 2022 Accepting new patients
Twin Cities Physicians Professional Corporation CurrentSince Jul 1, 2023 Accepting new patients
St Francis Regional Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Divine Providence Heatlh Center Inc. Past Accepting new patients
Physician's Urgent Care P.a. Past Accepting new patients
Gillette Children's Specialty Healthcare Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

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

1415 Lilac Dr N
Ste 190
Minneapolis, MN 55422
Phone (763) 267-8701

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

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

4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000

3455 Plymouth Blvd
Ste 202
Plymouth, MN 55447
Phone (763) 447-4687

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

8170 Old Carriage Ct
Ste 100
Shakopee, MN 55379
Phone (952) 428-3600

Interoperability endpoints

  • Direct secure messaging: mohammad.fareed@485962286563332.direct.elationemr.com
  • Direct secure messaging: mfareed602210@excellian.direct.allina.com

Organizations & group practices 12

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1598839250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 PLYMOUTH BLVD STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554471551",
            "telephone_number": "763-657-1044",
            "fax_number": "952-295-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 PLYMOUTH BLVD",
            "address_2": "SUITE#: 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475544",
            "telephone_number": "763-657-1044",
            "fax_number": "952-295-0676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11670 Fountain Drive",
            "address_2": "Arbor Lakes-Regus Suite",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "55369",
            "country_code": "US",
            "telephone_number": "763-657-1044",
            "fax_number": "952-295-0676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Creek Ln S",
            "address_purpose": "LOCATION",
            "city": "Jordan",
            "state": "MN",
            "postal_code": "553521214",
            "country_code": "US",
            "telephone_number": "952-428-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAREED",
        "first_name": "MOHAMMAD",
        "middle_name": "TARIQ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423978400",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfareed602210@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "265 Creek Ln S",
            "city": "Jordan",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553521214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.