Individual provider Active NPI

Muna Saeed Farah

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1780247015
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2425971 Issued in MN
Practice address
1821 University Ave W Ste 225
Saint Paul, MN 55104-2895
Phone
(651) 434-4411
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2425971 MN
Family Nurse Practitioner 363LF0000X 2425971 MN Primary

Addresses

Primary practice location

1821 University Ave W Ste 225
Saint Paul, MN 55104-2895

Mailing address

1821 University Ave W Ste 131
Saint Paul, MN 55104-2849

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215001740 MN Practitioner - Nurse Practitioner 5890144851 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2425971MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Odam Medical Group CurrentSince Nov 6, 2023 Accepting new patients
Odam Medical Group Current Accepting new patients
Odam Medical Group CurrentSince Nov 6, 2023 Accepting new patients

Locations

6014 Lakeland Ave N
Minneapolis, MN 55428
Phone (612) 871-2312

1521 Northway Dr
Ste 116
Saint Cloud, MN 56303
Phone (320) 654-9838

Interoperability endpoints

  • Direct secure messaging: contactodammedicalgroup.com@omg-mn.direct.office.nextgen.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1780247015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 131",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 225",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042895",
            "telephone_number": "651-434-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAH",
        "first_name": "MUNA",
        "middle_name": "SAEED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2425971",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2425971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.