| Minneapolis Clinic Of Neurology, Ltd | |
|
4225 Golden Valley Rd Golden Valley MN 55422-4215 | |
| (763) 588-0661 | |
| (763) 287-2310 |
| Full Name | Minneapolis Clinic Of Neurology, Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4225 Golden Valley Rd, Golden Valley, Minnesota |
| Authorized Official Name and Position | Charles Haugen Horowitz (PRESIDENT) |
| Authorized Official Contact | 7633024114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minneapolis Clinic Of Neurology, Ltd 4225 Golden Valley Rd Golden Valley MN 55422-4215 Ph: (763) 588-0661 | Minneapolis Clinic Of Neurology, Ltd 4225 Golden Valley Rd Golden Valley MN 55422-4215 Ph: (763) 588-0661 |
| NPI Number | 1992739247 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 12/02/2009 |
| Medicare PECOS PAC ID | 5496668659 |
|---|---|
| Medicare Enrollment ID | O20031112000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992739247 | NPI | - | NPPES |
| 32833200 | Medicaid | WI | |
| 784810200 | Medicaid | MN | |
| 100273 | Other | MN | UCARE CLINIC # |
| 11651MI | Other | MN | BCBS OF MN PROVIDER # |
| 96287 | Other | MN | PREFERRED ONE CLINIC # |
| Provider Name | Sonia Coelho Mosch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356348494 PECOS PAC ID: 9739073628 Enrollment ID: I20040211000784 |
| Provider Name | Armantina M Espinosa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952354870 PECOS PAC ID: 4082501770 Enrollment ID: I20040227000806 |
| Provider Name | Masood R Ghazali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528012051 PECOS PAC ID: 1951361484 Enrollment ID: I20041019000046 |
| Provider Name | Xiaoming Dong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265488340 PECOS PAC ID: 9739145160 Enrollment ID: I20041207000682 |
| Provider Name | Rachel M Peterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376621169 PECOS PAC ID: 9133146715 Enrollment ID: I20051102000385 |
| Provider Name | Rajiv Kumar Aggarwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942247986 PECOS PAC ID: 8628008463 Enrollment ID: I20060221000108 |
| Provider Name | Joanne B Rogin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528006418 PECOS PAC ID: 3577570225 Enrollment ID: I20060321000471 |
| Provider Name | Alexander Zubkov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992721658 PECOS PAC ID: 0244260081 Enrollment ID: I20060810000345 |
| Provider Name | Jason R Cornelius |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982610739 PECOS PAC ID: 7719981620 Enrollment ID: I20060907000535 |
| Provider Name | Stephanie L Freadrich |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720177280 PECOS PAC ID: 4284632027 Enrollment ID: I20061110000107 |
| Provider Name | Praful M Kelkar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588656417 PECOS PAC ID: 5799783288 Enrollment ID: I20061116000368 |
| Provider Name | Ryan H Goeke |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780710061 PECOS PAC ID: 1850495631 Enrollment ID: I20070404000137 |
| Provider Name | Kerri J Lamberty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558377283 PECOS PAC ID: 6800978636 Enrollment ID: I20080131000467 |
| Provider Name | Elias Bazakos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437276573 PECOS PAC ID: 6901971431 Enrollment ID: I20080819000352 |
| Provider Name | Leland J Scott |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508803834 PECOS PAC ID: 4385789940 Enrollment ID: I20100306000322 |
| Provider Name | Janiece M Aldinger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194779389 PECOS PAC ID: 4486780731 Enrollment ID: I20100326000075 |
| Provider Name | Irfan M Altafullah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437103629 PECOS PAC ID: 5890876239 Enrollment ID: I20100326000079 |
| Provider Name | Moeen A Masood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275574717 PECOS PAC ID: 0345321782 Enrollment ID: I20100329000982 |
| Provider Name | Gail Joan Francis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326095910 PECOS PAC ID: 4183750169 Enrollment ID: I20100329001015 |
| Provider Name | Donald J Chadwick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598712465 PECOS PAC ID: 7012045560 Enrollment ID: I20100504000889 |
| Provider Name | Lisa J Nippoldt-baca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720314909 PECOS PAC ID: 5496871709 Enrollment ID: I20100923001307 |
| Provider Name | Matthew J Ostrander |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205049574 PECOS PAC ID: 9638206022 Enrollment ID: I20101105000506 |
| Provider Name | Raluca F Banica Wolters |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699741058 PECOS PAC ID: 6901094879 Enrollment ID: I20101218000055 |
| Provider Name | William Farouk Qubty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841511177 PECOS PAC ID: 4981876505 Enrollment ID: I20111004000267 |
| Provider Name | Lyla Kamsheh Veen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538325345 PECOS PAC ID: 9234393547 Enrollment ID: I20120619000063 |
| Provider Name | Michael B Salmela |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487979167 PECOS PAC ID: 9830339829 Enrollment ID: I20130716000597 |
| Provider Name | Gurdesh S Bedi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992908826 PECOS PAC ID: 2567594302 Enrollment ID: I20130729000883 |
| Provider Name | Daniel B Hayward |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821380577 PECOS PAC ID: 7315172483 Enrollment ID: I20131025000474 |
| Provider Name | Jillian Marie Schmitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396167672 PECOS PAC ID: 1951532696 Enrollment ID: I20140324000460 |
| Provider Name | Uchechi C Amajuoyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831320100 PECOS PAC ID: 1850523606 Enrollment ID: I20140410001071 |
| Provider Name | Andrew Bunney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114246113 PECOS PAC ID: 5597998096 Enrollment ID: I20140508000511 |
| Provider Name | Jessica Lauren Stulc |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225271646 PECOS PAC ID: 7517101314 Enrollment ID: I20140711001527 |
| Provider Name | Sailaja Enduri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316109697 PECOS PAC ID: 4385809177 Enrollment ID: I20140804000893 |
| Provider Name | Kristin Venables |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407116155 PECOS PAC ID: 7517122443 Enrollment ID: I20150610001934 |
| Provider Name | Natalia S Dorland |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114241676 PECOS PAC ID: 2163738386 Enrollment ID: I20150903000054 |
| Provider Name | Lisa R Weiberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568484491 PECOS PAC ID: 3274837588 Enrollment ID: I20160208000522 |
| Provider Name | Karen L Guba |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215958160 PECOS PAC ID: 8729382502 Enrollment ID: I20160216000241 |
| Provider Name | Rachel L Fine |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851610182 PECOS PAC ID: 2163675463 Enrollment ID: I20160216001547 |
| Provider Name | Quoc A Nguyen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376567222 PECOS PAC ID: 3375848112 Enrollment ID: I20160216002321 |
| Provider Name | Marri L Wolff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609095066 PECOS PAC ID: 0143525493 Enrollment ID: I20160224000710 |
| Provider Name | Jill R Honnoll |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629375142 PECOS PAC ID: 2062719016 Enrollment ID: I20160318001268 |
| Provider Name | Aboubakar Guma Omar Sharaf |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548572647 PECOS PAC ID: 8325339757 Enrollment ID: I20160615001367 |
| Provider Name | Jayasri Alapati |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043565757 PECOS PAC ID: 4789973413 Enrollment ID: I20160824000253 |
| Provider Name | Melissa N Castro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114202744 PECOS PAC ID: 9739316209 Enrollment ID: I20160902000899 |
| Provider Name | Rebecca Omeara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376996736 PECOS PAC ID: 6103100367 Enrollment ID: I20170307001490 |
| Provider Name | James Norby Porter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437521614 PECOS PAC ID: 8426335910 Enrollment ID: I20170510002982 |
| Provider Name | Yu Zhao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912923707 PECOS PAC ID: 7618027541 Enrollment ID: I20170705003532 |
| Provider Name | Marietta Mume Hoogs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497019475 PECOS PAC ID: 1456574854 Enrollment ID: I20190717000225 |
| Provider Name | Kate Anita Monroe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043584410 PECOS PAC ID: 9032446653 Enrollment ID: I20190806000240 |
| Provider Name | Stuart Bergman-bock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639463185 PECOS PAC ID: 8426341249 Enrollment ID: I20190821003912 |
| Provider Name | Akram Hussain Dastagir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952616690 PECOS PAC ID: 7719106152 Enrollment ID: I20200521000224 |
| Provider Name | Kimberly Kinsella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366900839 PECOS PAC ID: 7214341692 Enrollment ID: I20210126001663 |
| Provider Name | Brent M Berry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013263011 PECOS PAC ID: 3476829342 Enrollment ID: I20210608001850 |
| Provider Name | Chinyere Ihunnah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821683525 PECOS PAC ID: 8729496351 Enrollment ID: I20210909000044 |
| Provider Name | Humera Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184210528 PECOS PAC ID: 2961883061 Enrollment ID: I20220720003775 |
| Provider Name | Victoria Anne Levasseur |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538519137 PECOS PAC ID: 7113340621 Enrollment ID: I20220831000556 |
| Provider Name | Adam Jeffrey Flemming |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376158097 PECOS PAC ID: 7214346477 Enrollment ID: I20220923001080 |
| Provider Name | Denijal Gluhic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477283216 PECOS PAC ID: 3577949247 Enrollment ID: I20221004000493 |
| Provider Name | Loriann Theresia Novak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720792682 PECOS PAC ID: 9638540891 Enrollment ID: I20230125003413 |
| Provider Name | Kayla Guerrero Joyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033887898 PECOS PAC ID: 6204209489 Enrollment ID: I20230309000843 |
| Provider Name | Mona Mostafa Sonbol |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639674930 PECOS PAC ID: 9638534068 Enrollment ID: I20230508001317 |
| Provider Name | Jessica Ann Piche |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376039412 PECOS PAC ID: 7618228032 Enrollment ID: I20230512002133 |
| Provider Name | Deanna Phan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215620430 PECOS PAC ID: 0345600011 Enrollment ID: I20230713002352 |
| Provider Name | Catherine Boissoneault |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699469932 PECOS PAC ID: 2860838802 Enrollment ID: I20240312003379 |
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