MEDICARE: MINNESOTA EPILEPSY GROUP PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
2	2084N0400X	Neurology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932118056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINNESOTA EPILEPSY GROUP PA

Provider Business Mailing Address
First Line	:	2720 FAIRVIEW AVE N STE 100
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-1306
Country	:	US
Telephone Number	:	651-241-5290
Fax Number	:	651-241-5248

Provider Business Practice Location Address
First Line	:	2720 FAIRVIEW AVE N STE 100
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-1306
Country	:	US
Telephone Number	:	651-241-5290
Fax Number	:	651-241-5248

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KINSHUK SAHAYA
Credential	:	MD
Telephone Number	:	651-377-8329

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	04/06/2026

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Directions to “MINNESOTA EPILEPSY GROUP PA ” Practice Location

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