Mina Tadros

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2530591 Issued in MN

Practice address

1020 W Broadway Ave
Minneapolis, MN 55411-2504

Phone

(612) 895-3850

NPI assigned

Mar 18, 2025

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Medical Services Montana Private LLC

  • Methadone Clinic
  • Minneapolis, MN
  • NPI 1033804653
  NPD (past)
• Community Medical Services Montana-Private, LLC

  • Methadone Clinic
  • Roseville, MN
  • NPI 1053069005
  NPD (past)

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1861292773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 10TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W BROADWAY AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112504",
            "telephone_number": "612-895-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROS",
        "first_name": "MINA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2530591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "1020 W Broadway Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554112504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anil Kumar Tadavarthy, MD
• S Murthy Tadavarthy, MD
• Yanick Tade, MD
• Charles Marcus Tademy IV, PHARMD
• Etalem Mekonnen Tadesse
• Erin Elizabeth Tadych
• Maram Taema, BDS, MS
• Jordan Taffet, LICSW
• Stephanie Taggart, APRN, CNP
• Sepi M Taghizadeh, DDS

• Registered Nurse in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.