Muktar Shillow Omar, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13976 Issued in MN

Practice address

6200 Shingle Creek Pkwy Ste 260
Brooklyn Center, MN 55430-2128

Phone

(763) 544-0696

Fax

(763) 544-0984

NPI assigned

Mar 4, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1689529505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12372 5TH ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554342644",
            "telephone_number": "612-227-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY STE 260",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302128",
            "telephone_number": "763-544-0696",
            "fax_number": "763-544-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAR",
        "first_name": "MUKTAR",
        "middle_name": "SHILLOW",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane M Ollendick Wright, LICSW, CPRP
• Carl Olson-Skog
• April Marie Olson, LICSW
• Colin David Olson
• Spencer Olson, LP
• Omnihealing Therapeutic Services
• Omocare LLC
• Adetomi Omotayo
• Sylvester A Onaiwu, REGISTERED NURSE
• Kyle P Onan, DO

• Family Nurse Practitioner in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.