Individual provider Active NPI

Hassan Hussein Sirat, RN

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1639736150
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8162 Issued in MN
Practice address
1068 Raymond Ave Apt 204
Saint Paul, MN 55108-1535
Phone
(651) 666-0846
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 2331230 MN
Family Nurse Practitioner 363LF0000X 8162 MN Primary

Addresses

Primary practice location

1068 Raymond Ave Apt 204
Saint Paul, MN 55108-1535

Mailing address

1068 Raymond Ave Apt 204
Saint Paul, MN 55108-1535
Phone (651) 666-0846

Other identifiers 2

IdentifierTypeStateIssuer
389359MedicaidMN
2331230MedicaidMN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211117001122 MN Practitioner - Nurse Practitioner 0648669440 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2331230MNMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Family Practice LLC CurrentSince Aug 10, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Oct 28, 2022 Accepting new patients
Park Place Unity Clinic LLC Current Accepting new patients
Regional Home Healthcare LLC Home Health Current Accepting new patients

Locations

1743 7th St S
Saint Cloud, MN 56301

1010 Dale St N
Saint Paul, MN 55117
Phone (612) 482-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1639736150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 RAYMOND AVE APT 204",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081535",
            "telephone_number": "651-666-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 RAYMOND AVE APT 204",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081535",
            "telephone_number": "651-666-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAT",
        "first_name": "HASSAN",
        "middle_name": "HUSSEIN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2331230",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389359",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331230",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.