DR. SEYYED HOSSEIN FATEMI, M.D., PHD - NPI NUMBER 1477582765

Summary

Provider Name: DR. SEYYED HOSSEIN FATEMI, M.D., PHD

NPI Number: 1477582765

Clasification: Psychiatry & Neurology (2084P2900X)

Specialization: Pain Medicine

Address:
UNIVERSITY OF MINNESOTA PHYSICIANS
2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST
MINNEAPOLIS, MN
ZIP 55454

Phone Number: (612) 273-8700



Detailed Information

DR. Seyyed Hossein Fatemi, M.D., PHD is a pain medicine psychiatrist in Minneapolis, MN. The provider is a neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. The assigned NPI number for this provider is 1477582765 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

UNIVERSITY OF MINNESOTA PHYSICIANS
2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST
MINNEAPOLIS, MN
ZIP 55454
Phone: (612) 273-8700

The enumeration date for this NPI number is 7/1/2006 and was last updated on 6/5/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2084P2900X Psychiatry & Neurology Pain Medicine 39034 MN No
2 2084P0800X Psychiatry & Neurology Psychiatry 39034 MN Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 15-41774 OTHER MN UBH
2 HP22337 OTHER MN HEALTHPARTNERS
3 0999508 MEDICAID IA
4 1012200 OTHER MN PREFERRED ONE
5 768106 OTHER MN ARAZ
6 124723900 MEDICAID MN
7 34Y45FA OTHER MN BCBS
8 32252200 MEDICAID WI
9 F83389 MEDICARE UPIN MN
10 260001378 MEDICARE ID-TYPE UNSPECIFIED MN MEDICARE
11 15-83243 OTHER MN MEDICA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1477582765 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name FATEMI The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name SEYYED The first name of the provider, if the provider is an individual.
5 Provider Middle Name HOSSEIN The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text M.D., PHD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address UNIVERSITY OF MINNESOTA PHYSICIANS The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Second Line Business Practice Location Address 2312 SOUTH 6TH STREET, SUITE F256 / 2B WEST The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
10 Provider Business Practice Location Address City Name MINNEAPOLIS The city name in the location address of the provider being identified.
11 Provider Business Practice Location Address State Name MN The State code in the location of the provider being identified.
12 Provider Business Practice Location Address Postal Code 55454 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
13 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
14 Provider Business Practice Location Address Telephone Number 6122738700 The telephone number associated with the location address of the provider being identified.
15 Provider Enumeration Date 7/1/2006 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 6/5/2012 The date that a record was last updated or changed.
17 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 2084P2900X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 39034 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 MN The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 N
22 Healthcare Provider Taxonomy Code 2 2084P0800X
23 Provider License Number 2 39034 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
24 Provider License Number State Code 2 MN The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
25 Healthcare Provider Primary Taxonomy Switch 2 Y
26 Other Provider Identifier 1 15-41774 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 1 MN
29 Other Provider Identifier Issuer 1 UBH
30 Other Provider Identifier 2 HP22337 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier State 2 MN
33 Other Provider Identifier Issuer 2 HEALTHPARTNERS
34 Other Provider Identifier 3 0999508 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
35 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier State 3 IA
37 Other Provider Identifier 4 1012200 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
38 Other Provider Identifier Type Code 4 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
39 Other Provider Identifier State 4 MN
40 Other Provider Identifier Issuer 4 PREFERRED ONE
41 Other Provider Identifier 5 768106 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
42 Other Provider Identifier Type Code 5 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
43 Other Provider Identifier State 5 MN
44 Other Provider Identifier Issuer 5 ARAZ
45 Other Provider Identifier 6 124723900 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
46 Other Provider Identifier Type Code 6 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
47 Other Provider Identifier State 6 MN
48 Other Provider Identifier 7 34Y45FA Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
49 Other Provider Identifier Type Code 7 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
50 Other Provider Identifier State 7 MN
51 Other Provider Identifier Issuer 7 BCBS
52 Other Provider Identifier 8 32252200 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
53 Other Provider Identifier Type Code 8 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
54 Other Provider Identifier State 8 WI
55 Other Provider Identifier 9 F83389 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
56 Other Provider Identifier Type Code 9 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
57 Other Provider Identifier State 9 MN
58 Other Provider Identifier 10 260001378 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
59 Other Provider Identifier Type Code 10 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
60 Other Provider Identifier State 10 MN
61 Other Provider Identifier Issuer 10 MEDICARE
62 Other Provider Identifier 11 15-83243 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
63 Other Provider Identifier Type Code 11 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
64 Other Provider Identifier State 11 MN
65 Other Provider Identifier Issuer 11 MEDICA
66 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.