Active NPI
Amina Iman, PA
- Physician Assistant
- Minneapolis, MN
National Provider Identifier
1821632118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13205
- Practice address
- 425 20TH Ave S
Minneapolis, MN 55454-4400 - Phone
- (612) 332-4973
- NPI assigned
- Oct 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13205 | MN | Primary |
Addresses
Primary practice location
425 20TH Ave S
Minneapolis, MN 55454-4400
Mailing address
425 20TH Ave S
Minneapolis, MN 55454-4400
Phone (612) 332-4973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200302001085 | MN | Practitioner - Physician Assistant | 5395172456 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- amina.iman@811393367080964.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1821632118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 20TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554544400",
"telephone_number": "612-332-4973",
"fax_number": "612-238-3534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 20TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554544400",
"telephone_number": "612-332-4973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMAN",
"first_name": "AMINA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-30",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.