Suanur Alp, MD

Individual provider Active NPI Pediatrics Physician · Minneapolis, MN

NPI 1679260616 · NPPES record last updated Jun 28, 2026

Key facts

NPI
1679260616
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
87558-20 (WI)
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 624-4477
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230719002460 MN Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
2668832833

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 87558-20 WI Yes

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

2450 Riverside Ave
M136, 1St Floor, East Building 8950a
Minneapolis, MN 55454
Phone (612) 624-4477

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Pediatrics Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.