Individual provider Active NPI

Ayham Moty, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1215972013
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48713 Issued in MN
Practice address
5 W Lake St
Minneapolis, MN 55408-3117
Phone
(612) 545-9222
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48713 MN Primary

Addresses

Primary practice location

5 W Lake St
Minneapolis, MN 55408-3117

Mailing address

5 W Lake St
Minneapolis, MN 55408-3117

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
I20060623000219 MN Practitioner - Family Practice 4789696394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

2810 Nicollet Ave
Minneapolis, MN 55408-4708
Phone (612) 873-6963

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

Hospital & facility affiliations

  • Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc CurrentSince Jan 1, 2012 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jan 1, 2012 Accepting new patients
Hennepin Faculty Associates Past Accepting new patients
Hennepin Healthcare System, Inc Past Accepting new patients
Hennepin Faculty Associates Past Accepting new patients

Locations

914 S 8th St
Ste D4
Minneapolis, MN 55404
Phone (612) 347-3744

2810 Nicollet Ave
Minneapolis, MN 55408
Phone (612) 545-9000

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

914 S 8th St
#D4
Minneapolis, MN 55404
Phone (612) 347-6450

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1215972013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083117",
            "telephone_number": "612-545-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTY",
        "first_name": "AYHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "48713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.