MECCA MEDICAL CENTER, LLC
NPI 1336790864
Family Medicine in Minneapolis, MN
About Mecca Medical Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MECCA MEDICAL CENTER, LLC (NPI 1336790864) is a healthcare organization registered as a family medicine in Minneapolis, Minnesota and active in the NPI registry since September 2019. The organization lists Idriss Ibrahim, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mecca Medical Center, 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 Mecca Medical Center, 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 Mecca Medical Center, LLC's NPI number?
The NPI number for Mecca Medical Center, LLC is 1336790864. It was assigned to this organization in the NPPES registry on September 25, 2019.
Where is Mecca Medical Center, LLC located?
Mecca Medical Center, LLC is located at 1113 E Franklin Ave Ste 106, Minneapolis, MN 55404. The listed phone number is (507) 530-6028.
What is Mecca Medical Center, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mecca Medical Center, LLC enrolled in Medicare?
Yes. Mecca Medical Center, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mecca Medical Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mecca Medical Center, 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 Mecca Medical Center, LLC was last updated on October 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.
# Mecca Medical Center, Llc · NPI 1336790864
Family Medicine organization in Minneapolis, Minnesota. Organization record, active in the CMS NPPES registry since September 25, 2019.
## Identity
- **NPI:** 1336790864 (Entity type: Organization)
- **Enumerated:** September 25, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Idriss Ibrahim, MEDICAL DIRECTOR
## Practice location
- **Address:** 1113 E FRANKLIN AVE STE 106, Minneapolis, MN 55404-2978
- **Phone:** (507) 530-6028
## 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:** October 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1336790864) · Data from the CMS NPPES public registry.