Individual provider Active NPI

Mohammed Azeemuddin, APRN, CNP

  • Family Nurse Practitioner
  • Baxter, MN
National Provider Identifier
1144693169
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP4943 Issued in MN
Practice address
13060 Isle Dr
Baxter, MN 56425-8331
Phone
(218) 828-2880
NPI assigned
Nov 13, 2015
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201704860NP-PP OR
Family Nurse Practitioner 363LF0000X CNP4943 MN Primary
Nurse Practitioner 363L00000X 4943 MN
Family Nurse Practitioner 363LF0000X 209013457 IL

Addresses

Primary practice location

13060 Isle Dr
Baxter, MN 56425-8331

Mailing address

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 828-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160104001131 IL Practitioner - Nurse Practitioner 1951603240 Reassigns benefits to 2 organizations
I20161229001732 MN Practitioner - Nurse Practitioner 1951603240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4943MNMDClinical Psychologist
CNP4943MNMDFamily Nurse Practitioner
201704860NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota CurrentSince Nov 11, 2024 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Jul 1, 2016 Accepting new patients
Wellnow Urgent Care, PC CurrentSince May 27, 2024 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Nov 11, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 1620
Chicago, IL 60675

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

Organizations & group practices 5

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

Hospital & facility affiliations 2

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": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1144693169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 ISLE DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258331",
            "telephone_number": "218-828-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 ISLE DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258331",
            "telephone_number": "218-828-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEEMUDDIN",
        "first_name": "MOHAMMED",
        "name_prefix": "Mr.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-13",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201704860NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4943",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "4943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.