NPIMap

Individual provider Active NPI

Wajahat Mirza, MD

  • Cardiovascular Disease Physician
  • Grayslake, IL
National Provider Identifier
1245231570
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-087622 Issued in IL
Practice address
1170 E Belvidere Rd
Suite 212
Grayslake, IL 60030-2061
Phone
(847) 543-6814
Fax
(847) 543-0787
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036-087622 IL Primary

Addresses

Primary practice location

1170 E Belvidere Rd
Suite 212
Grayslake, IL 60030-2061

Mailing address

1170 E Belvidere Rd
Suite 212
Grayslake, IL 60030-2061
Phone (847) 543-6814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041228000413 IL Practitioner - Cardiovascular Disease (Cardiology) 7911965819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1170 E Belvidere Rd
Suite 212
Grayslake, IL 60030-2034
Phone (847) 543-6814

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.7 of 100Reported as individual
Quality
91.55
Improvement activities
40
Cost
77.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-087622ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wajahat Mirza MD SC Cardiovascular Disease CurrentSince Nov 1, 2001 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Cardiovascular Institute of the South, LLC Cardiovascular Disease PastSince Apr 16, 2015 Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients

Locations

1170 E Belvidere Rd
Ste 212
Grayslake, IL 60030
Phone (847) 244-6800

Interoperability endpoints

  • Direct secure messaging: wajahat.mirza.1@14731.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14731/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 8

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1245231570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "SUITE 212",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-543-6814",
            "fax_number": "847-543-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "SUITE 212",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302061",
            "telephone_number": "847-543-6814",
            "fax_number": "847-543-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "WAJAHAT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-087622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.