Tashitaa Tufaa, PRESIDENT & CEO

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

370010 Issued in MN

Practice address

8260 Hickory St NE
Fridley, MN 55432-1002

Phone

(763) 571-1541

Fax

(763) 541-1547

NPI assigned

Jan 14, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1649636044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 HICKORY ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321002",
            "telephone_number": "763-571-1541",
            "fax_number": "763-541-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 HICKORY ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554321002",
            "telephone_number": "763-571-1541",
            "fax_number": "763-541-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUFAA",
        "first_name": "TASHITAA",
        "credential": "PRESIDENT & CEO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MN",
            "license": "370010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9JI05ME",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP",
            "identifier": "A392138100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Fridley, MN
• Providers in Fridley, MN by specialty
• Non-emergency Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.