MR. SAMUEL MORACHA BIRUNDU (NPI# 1225430317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225430317 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL MORACHA BIRUNDU |
| Credential | CNP |
| Practice Address |
5861 Cedar Lake Rd S St Louis Park MN 55416-1653 |
| Mailing Address |
10721 Smetana Rd Apt 206 Minnetonka MN 55343-8081 |
| Practice Telephone | 7635441000 |
| Mailing Telephone | 9529943619 |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
R 157904-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5861 CEDAR LAKE RD S |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-1653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954481 | Travis Scott Michaels | Counselor | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2020-08-28 |
| 1710590914 | Melissa Norland | Counselor | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2020-08-26 |
| 1558992123 | Selah Joy Smith | Counselor | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2020-01-31 |
| 1588044317 | Andrea Nicole Horvath | Occupational Therapist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2015-06-07 |
| 1851793020 | On Call Clinicians | Case Management | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2014-09-19 |
| 1033451372 | Robbie Fast | Speech-Language Pathologist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2013-03-25 |
| 1821338484 | On Call Medical Inc | Optometrist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1481 | 2013-02-19 |
| 1467640029 | Doorstep Dental Services | Dentist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1481 | 2007-10-09 |
| 1033307046 | Doorstep Healthcare Services | Dentist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1481 | 2007-10-04 |
| 1982827713 | Ashley Ann Bowles | Physical Therapist | 5861 Cedar Lake Rd S, St Louis Park, MN 55416-1653 | 2007-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1669005948 | Kevin Charles Carlson | Nurse Practitioner | 19303 Sorrel Ct, Corcoran, MN 55340-4447 | 2020-02-14 |
| 1144862996 | Alade Lateef Hamza | Nurse Practitioner | 4808 85th Ave N Ste 300, Brooklyn Park, MN 55443-1816 | 2019-10-14 |
| 1114584869 | Tenzin Lhamo | Nurse Practitioner | 195 Windsor Ln, New Brighton, MN 55112-3366 | 2019-05-28 |
| 1255834859 | Ashley M Morehouse | Nurse Practitioner | 625 S 4th St Ste A, Le Sueur, MN 56058-2203 | 2018-03-10 |
| 1013457381 | Lydia Nyakonu Sherman | Nurse Practitioner | 606 24th Ave S #620, Minneapolis, MN 55454 | 2017-03-06 |
| 1912447780 | Zillah Mulubisha | Nurse Practitioner | Brooklyn Park Clinic, 7650 Zane Ave N, Minneapolis, MN 55443 | 2017-02-27 |
| 1245615194 | Jennifer Nelson | Nurse Practitioner | 480 Osborne Rd Ne Ste 220, Fridley, MN 55432-2866 | 2015-07-21 |
| 1912397142 | Solomon Africanus Wesseh Jr. | Nurse Practitioner | 10135 43rd Ct Ne, Saint Michael, MN 55376-3015 | 2015-01-26 |
| 1780084004 | Angela Rae Fox | Nurse Practitioner | 7383 Upper 157th St W, Apple Valley, MN 55124-5108 | 2014-08-25 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on MR. SAMUEL MORACHA BIRUNDU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.