NPIMap

Individual provider Active NPI

Pezhman Samimian, MD

  • Internal Medicine Physician
  • Shakopee, MN
National Provider Identifier
1770744880
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60327 Issued in MN
Practice address
1455 Saint Francis Ave
Shakopee, MN 55379-3374
Phone
(952) 428-3000
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60327 MN Primary

Addresses

Primary practice location

1455 Saint Francis Ave
Shakopee, MN 55379-3374

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-1166

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address psamimiantehrani321308@excellian.direct.allina.com Direct
Direct Messaging Address psamimiantehrani321308@excellian.direct.allina.com Direct
Direct Messaging Address psamimiantehrani321308@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160506000119 MN Practitioner - Internal Medicine 9830235720 Reassigns benefits to 4 organizations
I20190923002051 WI Practitioner - Internal Medicine 9830235720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

Hospital & facility affiliations

  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Feb 1, 2017 Accepting new patients
Allina Health System Internal Medicine CurrentSince Jun 27, 2016 Accepting new patients
Fairview Express Care CurrentSince Apr 22, 2017 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Current Accepting new patients
Fairview Health Services CurrentSince Apr 22, 2017 Accepting new patients
Fairview Health Services Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Allina Health System CurrentSince Jun 27, 2016 Accepting new patients
Park Nicollet Clinic CurrentSince Feb 1, 2017 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Allina Health System CurrentSince Sep 6, 2019 Accepting new patients
St Francis Regional Medical Center Past Accepting new patients

Locations

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1770744880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 SAINT FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793374",
            "telephone_number": "952-428-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMIMIAN",
        "first_name": "PEZHMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "60327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psamimiantehrani321308@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psamimiantehrani321308@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "psamimiantehrani321308@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.