Individual provider Active NPI

Mohamed Ararso Ereso, MNDOT 385639

  • Transportation Network Company
  • St Louis Park, MN
National Provider Identifier
1962371633
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation Network CompanyTaxonomy code 342000000X
License
385639 Issued in MN
Practice address
5775 Wayzata Blvd # 754
St Louis Park, MN 55416-1222
Phone
(763) 703-0724
NPI assigned
Nov 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Network Company 342000000X 385639 MN Primary
Taxi 344600000X 76213 MN

Addresses

Primary practice location

5775 Wayzata Blvd # 754
St Louis Park, MN 55416-1222

Mailing address

5775 Wayzata Blvd # 754
St Louis Park, MN 55416-1222
Phone (763) 703-0724

Other identifiers 1

IdentifierTypeStateIssuer
394459504MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
385639MNMDTransportation Network Company
76213MNMDTaxi

NPI Registry JSON

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

{
    "created_epoch": "1761955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1962371633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD # 754",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "763-703-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD # 754",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "763-703-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERESO",
        "first_name": "MOHAMED",
        "middle_name": "ARARSO",
        "credential": "MNDOT 385639",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-01",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": "MN",
            "license": "385639",
            "primary": true
        },
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": "MN",
            "license": "76213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "394459504",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.