Mary Jennifer Abuzzahab, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

42796 Issued in MN

Practice address

345 Smith Ave N
Saint Paul, MN 55102-2346

Phone

(651) 220-6624

Fax

(651) 220-6064

NPI assigned

Aug 16, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Childrens Health Care

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1629161781
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1174515274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 LINCOLN DRIVE",
            "address_2": "CBC-2-REV/PE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361611",
            "telephone_number": "952-992-5624",
            "fax_number": "952-992-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "651-220-6624",
            "fax_number": "651-220-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUZZAHAB",
        "first_name": "MARY",
        "middle_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MN",
            "license": "42796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887951600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hamza Abubakar-Elmehra
• Chantale Abuh Fonji
• Hani Abukar
• Zubair Abukar
• Abundant Life Health Coaches, LLC
• Martha Jane Aby, MSW
• Academia Cesar Chevez Charter School
• Acadia St Paul JV, LLC
• Accentcare at Home of Minnesota, LLC
• Accentcare Fairview Home Health - West, LLC

• Pediatric Endocrinology Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pediatric Endocrinology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.