Individual provider Active NPI

Ijaz A Malik, MD

  • Cardiovascular Disease Physician
  • Milwaukee, WI
National Provider Identifier
1104893296
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
32806 Issued in WI
Practice address
960 N 12TH St
Suite 400
Milwaukee, WI 53233
Phone
(414) 219-7653
Fax
(414) 219-7676
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 32806-020 WI
Cardiovascular Disease Physician 207RC0000X 32806 WI Primary

Addresses

Primary practice location

960 N 12TH St
Suite 400
Milwaukee, WI 53233

Mailing address

PO Box 2040
Milwaukee, WI 53201-2040
Phone (414) 219-7653

Other identifiers 1

IdentifierTypeStateIssuer
34064500MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address imalik9363@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613001240 WI Practitioner - Cardiovascular Disease (Cardiology) 2567406382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1032 E Sumner St
Hartford, WI 53027-1608
Phone (262) 673-2300

1055 N Mayfair Rd
Wauwatosa, WI 53226-3436
Phone (414) 476-8450

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

205 Valley Ave
West Bend, WI 53095-5312
Phone (262) 338-1123

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

975 Port Washington Rd
Grafton, WI 53024-9204
Phone (262) 329-8650

W180N11070 River LN
Germantown, WI 53022-3109
Phone (262) 532-9700

Hospital & facility affiliations

  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32806-020WIMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Dec 1, 2008 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Mar 14, 2011 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Mar 14, 2011 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Dec 1, 2008 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Heart Care Associates LLC Cardiovascular Disease Past Accepting new patients

Locations (25 of 29)

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

12500 W Bluemound Rd
Elm Grove, WI 53122
Phone (262) 780-3434

210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

975 Port Washington Rd
Ste 310
Grafton, WI 53024
Phone (262) 329-1000

2845 Greenbrier Rd
#1
Green Bay, WI 54311
Phone (920) 288-8100

123 N Military Ave
Green Bay, WI 54303
Phone (920) 494-3421

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000

1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

10117 74th St
Ste 110
Kenosha, WI 53142
Phone (262) 697-1919

601 Reed Ave
Manitowoc, WI 54220
Phone (920) 682-8841

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1218 W Kilbourn Ave
Milwaukee, WI 53233
Phone (414) 219-7343

960 N 12th St
Ste 400
Milwaukee, WI 53233
Phone (414) 219-7500

2801 W Kinnickinnic River Pkwy
Ste 440
Milwaukee, WI 53215
Phone (414) 385-2700

5017 S 110th St
Milwaukee, WI 53228
Phone (414) 427-8282

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Ste 401
Milwaukee, WI 53233
Phone (414) 219-7956

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Interoperability endpoints

  • Direct secure messaging: imalik9363@direct.myadvocateaurora.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1104893296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532012040",
            "telephone_number": "414-219-7653",
            "fax_number": "414-219-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N 12TH ST",
            "address_2": "SUITE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233",
            "telephone_number": "414-219-7653",
            "fax_number": "414-219-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "IJAZ",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "WI",
            "license": "32806-020",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "32806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34064500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imalik9363@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "960 N 12th St",
            "address_2": "Suite 400",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "960 N 12th St",
            "address_2": "Suite 400",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.