Individual provider Active NPI

Rebekah Radmanesh, M.D.

  • Psychiatry Physician
  • Anoka, MN
National Provider Identifier
1881743953
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
75886 Issued in MN
Practice address
3301 7TH Ave Ste 104
Anoka, MN 55303-4516
Phone
(651) 431-5000
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 103297 MO
Psychiatry Physician 2084P0800X 75886 MN Primary

Addresses

Primary practice location

3301 7TH Ave Ste 104
Anoka, MN 55303-4516

Mailing address

3200 Labore Rd.
Suite 104
Vadnais Heights, MN 55110-5186

Other identifiers 1

IdentifierTypeStateIssuer
208589846MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924004049 MN Practitioner - Psychiatry 4981679263 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75886MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anoka Metro Regional Treatment Center CurrentSince Aug 7, 2024 Accepting new patients
Scott J Arbaugh MD Psychiatry Past Accepting new patients
NPI 1467448274 Past Accepting new patients
Essex County Treasurer Past Accepting new patients
Matrix Health Systems P.C. Past Accepting new patients
Northern Lights Sleep Medicine, PC Past Accepting new patients
Northwest Psychiatric Associates, LTD Psychiatry Past Accepting new patients

Locations

3301 7th Ave
Ste 104
Anoka, MN 55303
Phone (651) 431-5000

3301 7th Ave
Anoka, MN 55303
Phone (651) 431-5000

3200 Labore Rd
Ste 104
Vadnais Heights, MN 55110
Phone (612) 387-9243

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1881743953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LABORE RD.",
            "address_2": "SUITE 104",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105186",
            "fax_number": "651-431-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 7TH AVE STE 104",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034516",
            "telephone_number": "651-431-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADMANESH",
        "first_name": "REBEKAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "103297",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "75886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208589846",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

Verify at the official NPI Registry.