Mustafe Ayube Ibrahim

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3435 Washington Dr Ste 206
Eagan, MN 55122-1339

Phone

(651) 888-0471

NPI assigned

Apr 12, 2024

Last updated

Apr 12, 2024By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Home and Community Choice LLC

  • Early Intervention Provider Agency
  • Eagan, MN
  • NPI 1114707692
  NPD

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1821842378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 WASHINGTON DR STE 206",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 WASHINGTON DR STE 206",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221339",
            "telephone_number": "651-888-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MUSTAFE",
        "middle_name": "AYUBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hy-Vee Health PC
• Hy-Vee Inc (Hy-Vee Pharmacy (1165))
• Hy-Vee Inc (Hy-Vee Pharmacy Fulfillment Center (4044))
• Christina Rae Paulsen Hyser, MD
• Muna Ibrahim, BT
• Suudi D Ibrahim
• Ideal Dental PLLC
• Ideal Homecare, LLC
• Jennifer Ihbe-Eberts
• Patience Imade Ikonagbon

• Behavior Technician in Eagan, MN
• Providers in Eagan, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.