Individual provider Active NPI

Nersi Nikakhtar, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1982620332
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44917-020 Issued in WI
Practice address
1 Veterans Dr
1110
Minneapolis, MN 55417-2309
Phone
(612) 467-1964
Fax
(612) 467-1913
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44917-020 WI Primary

Addresses

Primary practice location

1 Veterans Dr
1110
Minneapolis, MN 55417-2309

Mailing address

7201 Walker St Apt 416
St Louis Park, MN 55426-4185
Phone (612) 802-9978

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
I20170608001227 MN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850571753

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44917-020WIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982620332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 WALKER ST APT 416",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264185",
            "telephone_number": "612-802-9978",
            "fax_number": "612-467-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "address_2": "1110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-1964",
            "fax_number": "612-467-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKAKHTAR",
        "first_name": "NERSI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "44917-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.