NPIMap

Individual provider Active NPI

Nissim Khabie, M.D.

  • Otolaryngology Physician
  • Minneapolis, MN
National Provider Identifier
1851393839
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
42203 Issued in MN
Practice address
2211 Park Ave
Minneapolis, MN 55404-3711
Phone
(612) 871-1144
Fax
(612) 871-2012
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 42203 MN Primary

Addresses

Primary practice location

2211 Park Ave
Minneapolis, MN 55404-3711

Mailing address

2211 Park Ave
Minneapolis, MN 55404-3711
Phone (612) 871-1144

Other identifiers 8

IdentifierTypeStateIssuer
34190100OtherWIMEDICAID - WISCONSIN
1000350OtherMNMEDICA CHOICE
1000010OtherMNMEDICA PRIMARY
1592346OtherMNAMERICA'S PPO
01031020OtherMNPREFERREDONE
141063OtherMNUCARE
951427900MedicaidMN
055M7KHOtherMNBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nkhabie85448@excellian.direct.allina.com Direct

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
I20100414000816 MN Practitioner - Otolaryngology 0840219085 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Francisco School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians
Ear Nose and Throat Specialty Care of Minnesota PAGroup PAC ID 3274524020, 46 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

6099 Wayzata Blvd
Suite 200
St Louis Park, MN 55416-5538
Phone (612) 871-1144

9822 Hospital Dr
Maple Grove, MN 55369-4648
Phone (612) 871-1144

Hospital & facility affiliations

  • Cambridge Medical Center Hospital, Cambridge, MN, CCN 240020
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Merit-based Incentive Payment System (MIPS)

Final score
77.11 of 100Reported as group
Quality
63.28
Promoting interoperability
91
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Ear Nose & Throat Specialty Care of Minnesota PA Otolaryngology CurrentSince Aug 1, 2002 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System CurrentSince May 1, 2011 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients

Locations

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

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

9550 Upland Ln N
Ste 200
Maple Grove, MN 55369
Phone (612) 871-1144

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

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

3960 Coon Rapids Blvd NW
Ste 104
Minneapolis, MN 55433
Phone (763) 236-9000

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2211 Park Ave
Minneapolis, MN 55404
Phone (612) 871-1144

6099 Wayzata Blvd
Ste 200
St Louis Park, MN 55416
Phone (612) 871-1144

Interoperability endpoints

  • Direct secure messaging: nissim.khabie@entsc.eclinicaldirectplus.com
  • Direct secure messaging: nkhabie85448@excellian.direct.allina.com

Organizations & group practices 6

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.

Hospital & facility affiliations 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1851393839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043711",
            "telephone_number": "612-871-1144",
            "fax_number": "612-871-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHABIE",
        "first_name": "NISSIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "42203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - WISCONSIN",
            "identifier": "34190100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "1000350",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "1000010",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "1592346",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "01031020",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "141063",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951427900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "055M7KH",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkhabie85448@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "701 Dellwood St S",
            "city": "Cambridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550081920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.