Individual provider Active NPI

Ahmad Raza, MD

  • Hematology & Oncology Physician
  • Edina, MN
National Provider Identifier
1598887895
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
300472 Issued in NY
Practice address
6363 France Ave S Ste 610
Edina, MN 55435-2144
Phone
(952) 836-2600
NPI assigned
Apr 6, 2007
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51630 MN
Internal Medicine Physician 207R00000X 35.89191 OH
Internal Medicine Physician 207R00000X 300472 NY
Hematology & Oncology Physician 207RH0003X 51630 MN
Hematology & Oncology Physician 207RH0003X 300472 NY Primary
Hospitalist Physician 208M00000X 35.89191 OH

Addresses

Primary practice location

6363 France Ave S Ste 610
Edina, MN 55435-2144

Mailing address

5205 Kimberly LN N
Plymouth, MN 55446-1441

Other identifiers 1

IdentifierTypeStateIssuer
2766510MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090330000339 MN Practitioner - Internal Medicine 0941301303 Reassigns benefits to 1 organization
I20191010000187 NY Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 0941301303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
300472NYMDRegistered Nurse
51630MNMDHematology & Oncology Physician
35.89191OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
The Westchester Medical Practice, PC CurrentSince Sep 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Apr 23, 2019 Accepting new patients
The Westchester Medical Practice, PC CurrentSince Sep 1, 2019 Accepting new patients
Incare LLC Internal Medicine Past Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1978 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 293-8450

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Interoperability endpoints

  • Direct secure messaging: ahr9007@direct.nyp.org

Organizations & group practices 6

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1598887895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 KIMBERLY LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554461441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 610",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352144",
            "telephone_number": "952-836-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "51630",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.89191",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "300472",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "51630",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "300472",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.89191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2766510",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.