Hadeel Ali Awwad Alzoubi, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1465 South Grand Boulevard
2ND Floor Glennon Hall, Room 2717
St. Louis, MO 63104-1003

Phone

(314) 577-5634

Fax

(314) 577-5616

NPI assigned

May 15, 2025

Reactivated

Jun 26, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1053102491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 SOUTH GRAND BOULEVARD",
            "address_2": "2ND FLOOR GLENNON HALL, ROOM 2717",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 SOUTH GRAND BOULEVARD",
            "address_2": "2ND FLOOR GLENNON HALL, ROOM 2717",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALZOUBI",
        "first_name": "HADEEL",
        "middle_name": "ALI AWWAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "deactivation_date": "2026-03-16",
        "reactivation_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.