Individual provider Active NPI

Maryama Ismail

  • Obstetrics & Gynecology Physician
  • Edina, MN
National Provider Identifier
1215513072
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
80594 Issued in MN
Practice address
6545 France Ave S Ste 490
Edina, MN 55435-2123
Phone
(952) 922-7600
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 80594 MN Primary

Addresses

Primary practice location

6545 France Ave S Ste 490
Edina, MN 55435-2123

Mailing address

6545 France Ave S Ste 490
Edina, MN 55435-2123
Phone (952) 922-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20251001002304 MN Practitioner - Obstetrics/Gynecology 9032518279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Mayo Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Sofia OBGYN PAGroup PAC ID 2466404991, 11 clinicians

Practice addresses (Care Compare)

6545 France Ave S
Suite 490
Edina, MN 55435-2123
Phone (952) 922-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80594MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Sofia OBGYN PA Obstetrics & Gynecology CurrentSince Sep 1, 2025 Accepting new patients

Locations

15715 Grove Cir N
Maple Grove, MN 55369
Phone (952) 922-7600

6545 France Ave S
Ste 490
Minneapolis, MN 55435
Phone (952) 922-7600

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mismail23821@direct.bostonchildrens.org
  • Direct secure messaging: maryama.ismail.p1@direct.clinicsofia.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1215513072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 490",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352123",
            "telephone_number": "952-922-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 490",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352123",
            "telephone_number": "952-922-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "MARYAMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "80594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.