Individual provider Active NPI

Nabeela Khan, PA-C

  • Physician Assistant
  • Crystal, MN
National Provider Identifier
1801510789
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14757 Issued in MN
Practice address
6014 Lakeland Ave N
Crystal, MN 55428-2984
Phone
(612) 871-2312
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14757 MN Primary

Addresses

Primary practice location

6014 Lakeland Ave N
Crystal, MN 55428-2984

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nkhan808769@excellian.direct.allina.com

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
I20240117004234 MN Practitioner - Physician Assistant 9436501285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Odam Medical Group CurrentSince Jan 2, 2024 Accepting new patients
Allina Health System CurrentSince Apr 6, 2026 Accepting new patients
Allina Health System CurrentSince Apr 6, 2026 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

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

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

Interoperability endpoints

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

Organizations & group practices 4

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1801510789",
    "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": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6014 LAKELAND AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554282984",
            "telephone_number": "612-871-2312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9055 Springbrook Dr NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335841",
            "country_code": "US",
            "telephone_number": "763-780-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NABEELA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkhan808769@excellian.direct.allina.com",
            "affiliation": "N",
            "address_1": "9055 Springbrook Dr NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554335841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

Verify at the official NPI Registry.