NPIMap

Individual provider Active NPI

Shaban Nazarian, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Chaska, MN
National Provider Identifier
1831381854
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
39394 Issued in MN
Practice address
111 Hundertmark Rd Ste 115N
Chaska, MN 55318-1584
Phone
(952) 361-2450
Fax
(952) 361-2461
NPI assigned
Aug 14, 2007
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 39394 MN Primary

Addresses

Primary practice location

111 Hundertmark Rd Ste 115N
Chaska, MN 55318-1584

Mailing address

500 S Maple St
Waconia, MN 55387-1791
Phone (952) 442-2191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607000922 MN Practitioner - EndocrinologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 1254313778 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Missouri, Columbia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Nov 2, 1998 Accepting new patients
Ridgeview Medical Center Current Accepting new patients
Fairview Clinics CurrentSince Nov 2, 1998 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Dec 29, 2012 Accepting new patients
Group Health Plan, Inc. CurrentSince Dec 29, 2012 Accepting new patients
Ridgeview Medical Center Past Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

1650 Beam Ave
Maplewood, MN 55109
Phone (651) 221-4316

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
Stillwater, MN 55082

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

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1831381854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871791",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD STE 115N",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181584",
            "telephone_number": "952-361-2450",
            "fax_number": "952-361-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIAN",
        "first_name": "SHABAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MN",
            "license": "39394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.