NPIMap

Individual provider Active NPI

Munir Jibril Abdalla

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1962909390
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
69389 Issued in MN
Practice address
2535 University Ave SE
Minneapolis, MN 55414-3205
Phone
(612) 672-2350
NPI assigned
Apr 11, 2018
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 69389 MN Primary

Addresses

Primary practice location

2535 University Ave SE
Minneapolis, MN 55414-3205

Mailing address

2535 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-2350

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mabdalla914773@direct.centracare.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
I20210824002712 MN Practitioner - Pediatric Medicine 9335487511 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29458MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Pediatrics CurrentSince Aug 1, 2021 Accepting new patients
Sahan Systems Inc Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Aug 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Centracare Clinic CurrentSince Jan 1, 2026 Accepting new patients
Fairview Clinics CurrentSince Aug 1, 2021 Accepting new patients
Centracare Clinic CurrentSince Jan 1, 2026 Accepting new patients
Fairview Health Services CurrentSince Aug 1, 2021 Accepting new patients
Recure Current Accepting new patients
Centracare Clinic Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

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

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2450 Riverside Ave
Rm M136
Minneapolis, MN 55454
Phone (612) 624-4418

2535 University Ave SE
Minneapolis, MN 55414
Phone (612) 672-2350

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

Interoperability endpoints

  • Direct secure messaging: mabdalla435972@fairview.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1962909390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143205",
            "telephone_number": "612-672-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143205",
            "telephone_number": "612-672-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLA",
        "first_name": "MUNIR",
        "middle_name": "JIBRIL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "69389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mabdalla914773@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mabdalla914773@direct.centracare.com",
            "address_1": "1200 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563032735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.