Active NPI
Khalil Wadih Simon Farah, M.D.
- Gastroenterology Physician
- Plymouth, MN
National Provider Identifier
1639363286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 56866
- Practice address
- 15700 37TH Ave N Ste 300
Plymouth, MN 55446-3661 - Phone
- (612) 871-1145
- Fax
- (612) 870-5491
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 56866 | MN | Primary |
Addresses
Primary practice location
15700 37TH Ave N Ste 300
Plymouth, MN 55446-3661
Mailing address
PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15700 37TH Ave N
Suite 300
Plymouth, MN 55446-3661
Phone (612) 871-1145
Hospital & facility affiliations
- North Memorial Health Hospital
- Mercy Hospital
- Abbott Northwestern Hospital
- Maple Grove Hospital
- Hutchinson Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 51 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 62 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56866 | MN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mngi Digestive Health, P.a. | Gastroenterology | Current | Accepting new patients |
Locations
701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005
701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334
15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555
15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008
Interoperability endpoints
- khalil.farahmd.p1@direct.mngastro.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Gastroenterology Physician
- Minneapolis, MN
- NPI 1609804541
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Addiction (Substance Use Disorder) Psychologist
- Fridley, MN
- NPI 1083197214
Hospital
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- General Acute Care Hospital
- Cambridge, MN
- NPI 1215755400
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Fridley, MN
- NPI 1285692145
-
- General Acute Care Hospital
- Coon Rapids, MN
- NPI 1316904287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1639363286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14909",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554140909",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15700 37TH AVE N STE 300",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554463661",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARAH",
"first_name": "KHALIL",
"middle_name": "WADIH SIMON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "56866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.