ADVANCED CARE CLINIC LLC
NPI 1174391940
Nurse Practitioner - Family in Minneapolis, MN
About Advanced Care Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVANCED CARE CLINIC LLC (NPI 1174391940) is a healthcare organization registered as a family in Minneapolis, Minnesota and active in the NPI registry since December 2023. The organization lists Ifrah A Abdullahi, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Advanced Care Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Advanced Care Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Advanced Care Clinic LLC's NPI number?
The NPI number for Advanced Care Clinic LLC is 1174391940. It was assigned to this organization in the NPPES registry on December 12, 2023.
Where is Advanced Care Clinic LLC located?
Advanced Care Clinic LLC is located at 1317 E Lake St Ste 4, Minneapolis, MN 55407. The listed phone number is (612) 285-3417.
What is Advanced Care Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Advanced Care Clinic LLC enrolled in Medicare?
Yes. Advanced Care Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Advanced Care Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Advanced Care Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Advanced Care Clinic LLC was last updated on December 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Advanced Care Clinic Llc · NPI 1174391940
Family organization in Minneapolis, Minnesota. Organization record, active in the CMS NPPES registry since December 12, 2023.
## Identity
- **NPI:** 1174391940 (Entity type: Organization)
- **Enumerated:** December 12, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Ifrah Abdullahi, OWNER
## Practice location
- **Address:** 1317 E LAKE ST STE 4, Minneapolis, MN 55407-6601
- **Phone:** (612) 285-3417 · **Fax:** (612) 254-8247
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 19, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1174391940) · Data from the CMS NPPES public registry.