Active NPI
Suleiman Abdisalan
- Behavior Analyst
- Waite Park, MN
National Provider Identifier
1992518336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 74 10TH Ave S
Waite Park, MN 56387-1055 - Phone
- (612) 636-5139
- Fax
- (612) 465-5056
- NPI assigned
- Jan 29, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
74 10TH Ave S
Waite Park, MN 56387-1055
Mailing address
74 10TH Ave S
Waite Park, MN 56387-1055
Phone (612) 636-5139
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Behavioral Center LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Waite Park, MN
- NPI 1699407148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1992518336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 10TH AVE S",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871055",
"telephone_number": "612-636-5139",
"fax_number": "612-465-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 10TH AVE S",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871055",
"telephone_number": "612-636-5139",
"fax_number": "612-465-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDISALAN",
"first_name": "SULEIMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.