NPIMap

Individual provider Active NPI

Ahmad Hazem, MD

  • Internal Medicine Physician
  • Duluth, MN
National Provider Identifier
1184902033
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
RL11971 Issued in ND
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8132
NPI assigned
Jul 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X RL11971 ND Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E. Third St.
Duluth, MN 58104-1951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140611001100 MN Practitioner - HospitalistPractitioner - Internal Medicine 8628292893 Reassigns benefits to 1 organization
I20200423000440 WI Practitioner - Internal MedicinePractitioner - Hospitalist 8628292893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
Northern Pines Medical CenterGroup PAC ID 3870565641, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

520 Osborne Rd NE
Fridley, MN 55432-2718

5211 Hwy 110
Aurora, MN 55705-1522
Phone (218) 229-3311

550 Osborne Rd NE
Fridley, MN 55432-2718
Phone (763) 427-9980

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (763) 689-8700

Hospital & facility affiliations

  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Cambridge Medical Center Hospital, Cambridge, MN, CCN 240020
  • Essentia Health Northern Pines Medical Center Hospital, Aurora, MN, CCN 241340
  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RL11971NDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 29, 2021 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 17, 2019 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Mar 1, 2020 Accepting new patients
Allina Health System CurrentSince Mar 29, 2021 Accepting new patients
Allina Health System Current Accepting new patients
St. Mary'S Hospital of Superior Current Accepting new patients
The Duluth Clinic, LTD CurrentSince Jun 17, 2019 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 8

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1184902033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E. THIRD ST.",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "581041951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEM",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "RL11971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.