MEDICARE: RISING IMPACT

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922674829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING IMPACT

Provider Business Mailing Address
First Line	:	1821 UNIVERSITY AVE W STE 178
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-2803
Country	:	US
Telephone Number	:	701-729-6691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 UNIVERSITY AVE W STE 178
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-2803
Country	:	US
Telephone Number	:	701-729-6691
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	ATIF IHSAN
Credential	:
Telephone Number	:	701-729-6691

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

Similar Medicare Providers

1487116307 — ERIC WITTKOPF
Practice Location Address:

1821 UNIVERSITY AVE W STE N180
SAINT PAUL, MN
55104-2803

Practice Phone: 651-366-2054
Practice Fax:

1699349332 — RISING IMPACT
Practice Location Address:

1821 UNIVERSITY AVE W STE 178
SAINT PAUL, MN
55104-2803

Practice Phone: 612-255-2534
Practice Fax:

1710649074 — SERNEE LLC
Practice Location Address:

1821 UNIVERSITY AVE W STE N180
SAINT PAUL, MN
55104-2803

Practice Phone: 651-276-0607
Practice Fax:

1780442228 — JAIA TSAB HAWJ
Practice Location Address:

1821 UNIVERSITY AVE W STE 178
SAINT PAUL, MN
55104-2803

Practice Phone: 612-505-2532
Practice Fax:

1417782798 — SUMAYA MAHAMUD
Practice Location Address:

1821 UNIVERSITY AVE W STE 169
SAINT PAUL, MN
55104-2803

Practice Phone: 651-348-3897
Practice Fax:

1336968775 — ELMI ABDULAZIZ ELMI
Practice Location Address:

1821 UNIVERSITY AVE W STE 169
SAINT PAUL, MN
55104-2803

Practice Phone: 651-341-3897
Practice Fax:

Directions to “RISING IMPACT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.