| Bluecrescent Urgent Care LLC | |
|
3809 42nd Ave S Ste 100 Minneapolis MN 55406-3503 | |
| (612) 405-3554 | |
| Not Available |
| Full Name | Bluecrescent Urgent Care LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3809 42nd Ave S Ste 100, Minneapolis, Minnesota |
| Authorized Official Name and Position | Khadra Muse (NURSE PRACTITIONER) |
| Authorized Official Contact | 7035983441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluecrescent Urgent Care LLC 3809 42nd Ave S Ste 100 Minneapolis MN 55406-3503 Ph: (612) 405-3554 | Bluecrescent Urgent Care LLC 3809 42nd Ave S Ste 100 Minneapolis MN 55406-3503 Ph: (612) 405-3554 |
| NPI Number | 1053034421 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 07/25/2024 |
| Certification Date | 02/20/2023 |
| Medicare PECOS PAC ID | 6608231659 |
|---|---|
| Medicare Enrollment ID | O20230427000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053034421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Abdulqadir Abdullahi Ahmad |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1366707556 PECOS PAC ID: 4880984475 Enrollment ID: I20161007001522 |
| Provider Name | Khadra Muse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013470715 PECOS PAC ID: 1557754652 Enrollment ID: I20220214001999 |
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