Active NPI
Shahrior Imrul Kayes, ANP-BC, C.N.P.
- Adult Health Nurse Practitioner
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R 183010 -1
- Practice address
- 5101 Minnehaha Ave
Minneapolis, MN 55417-1647 - Phone
- (612) 548-5830
- NPI assigned
- Apr 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R 183010 -1 | MN | Primary |
Addresses
Primary practice location
5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Mailing address
5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Phone (612) 548-5830
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120828000575 | MN | Practitioner - Nurse Practitioner | 6103073077 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- State of Minnesota-Minnesota Management and Budget
Practice addresses (Care Compare)
5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Phone (612) 548-5709
Hospital & facility affiliations
- M Health Fairview University of MN Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 183010 -1 | MN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Minnesota-Minnesota Management and Budget | Current | Accepting new patients | |
| State of Minnesota-Minnesota Management and Budget | Current | Accepting new patients |
Locations
5101 Minnehaha Ave
Minneapolis, MN 55417
Phone (612) 548-5709
5101 Minnehaha Ave
Bldg 10
Minneapolis, MN 55417
56 Outer Dr
Silver Bay, MN 55614
Phone (218) 226-6300
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 and National Provider Directory roles.
-
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MN
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- NPI 1609217900
-
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- NPI 1568735090
-
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- NPI 1891021390
-
- Skilled Nursing Facility
- Silver Bay, MN
- NPI 1952742256
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- Skilled Nursing Facility
- Bemidji, MN
- NPI 1023724838
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540857600000",
"number": "1659638690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5101 MINNEHAHA AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171647",
"telephone_number": "612-548-5830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101 MINNEHAHA AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171647",
"telephone_number": "612-548-5830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAYES",
"first_name": "SHAHRIOR",
"middle_name": "IMRUL",
"credential": "ANP-BC, C.N.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-16",
"last_updated": "2018-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "R 183010 -1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.