Individual provider Active NPI

Abdul Moiz Hafiz, MD

  • Interventional Cardiology Physician
  • Springfield, IL
National Provider Identifier
1225397219
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036141952 Issued in IL
Practice address
747 N Rutledge St
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-7877
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036141952 IL
Interventional Cardiology Physician 207RI0011X 036141952 IL Primary

Addresses

Primary practice location

747 N Rutledge St
Springfield, IL 62702-6700

Mailing address

PO Box 19627
Springfield, IL 62794-9627
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036141952MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abdulmoizhafiz@siusm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170713003398 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7517262488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting21
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036141952ILMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 10, 2017 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 10, 2017 Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

747 N Rutledge St
Springfield, IL 62702
Phone (217) 545-6112

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Interoperability endpoints

  • Direct secure messaging: abdulmoizhafiz@siusm.allscriptsdirect.net

Organizations & group practices 3

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 4

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1225397219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19627",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949627",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFIZ",
        "first_name": "ABDUL MOIZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036141952",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036141952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036141952",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abdulmoizhafiz@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "747 N Rutledge St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627026700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.