Individual provider Active NPI

Indrani Saha, M.D.

  • Pediatrics Physician
  • Blaine, MN
National Provider Identifier
1649409665
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61350 Issued in MN
Practice address
10961 Club West Pkwy
Blaine, MN 55449-5866
Phone
(763) 528-2987
Fax
(763) 528-2945
NPI assigned
Jul 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60280219 WA
Pediatrics Physician 208000000X 61350 MN Primary

Addresses

Primary practice location

10961 Club West Pkwy
Blaine, MN 55449-5866

Mailing address

400 Stinson Boulevard
Minneapolis, MN 55413-2614
Phone (612) 672-2258

Other practice location 1

515 W Court St
Pasco, WA 99301-3737
Phone (509) 547-2204

Other identifiers 1

IdentifierTypeStateIssuer
H400333131OtherMEDICARE PTAN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013001488 MN Practitioner - Pediatric Medicine 0446404107 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61350MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Fairview Health Services CurrentSince Sep 10, 2016 Accepting new patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Fairview Clinics CurrentSince Sep 10, 2016 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services Current Accepting new patients
Tri-Cities Community Health Past Accepting new patients
Fairview Clinics Past Accepting new patients
Tri Cities Community Health Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

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

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

Interoperability endpoints

  • Direct secure messaging: isaha385766@fairview.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1649409665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STINSON BOULEVARD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132614",
            "telephone_number": "612-672-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10961 CLUB WEST PKWY",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495866",
            "telephone_number": "763-528-2987",
            "fax_number": "763-528-2945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 W Court St",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993013737",
            "country_code": "US",
            "telephone_number": "509-547-2204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAHA",
        "first_name": "INDRANI",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60280219",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "61350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H400333131",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.