Individual provider Active NPI

Adnan Ajmal, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Phoenix, AZ
National Provider Identifier
1245494046
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
55957 Issued in AZ
Practice address
500 W Thomas Rd Ste 900B
Phoenix, AZ 85013-4224
Phone
(602) 406-3540
NPI assigned
Jul 11, 2008
Last updated
Jul 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301104590 MI
Internal Medicine Physician 207R00000X 50594 MN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301104590 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 55957 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 900B
Phoenix, AZ 85013-4224

Mailing address

3030 N Central Ave Ste 1001
Phoenix, AZ 85012-2716
Phone (602) 406-4786

Other practice location 1

655 S Dobson Rd Ste B113
Chandler, AZ 85224-5686
Phone (480) 728-5020

Other practice location 2

1500 East Medical Center Drive
3rd floor Med Inn Rm C333
Ann Arbor, MI 48109-5832
Phone (734) 763-9812

Other identifiers 1

IdentifierTypeStateIssuer
110091667AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50594MNMDInternal Medicine Physician
55957AZMDEndocrinology, Diabetes & Metabolism Physician
4301104590MIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Livi Medical Services LLC Family Medicine PastSince Aug 26, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1245494046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1001",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122716",
            "telephone_number": "602-406-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 900B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134224",
            "telephone_number": "602-406-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 S Dobson Rd Ste B113",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245686",
            "country_code": "US",
            "telephone_number": "480-728-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 East Medical Center Drive",
            "address_2": "3rd floor Med Inn Rm C333",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095832",
            "country_code": "US",
            "telephone_number": "734-763-9812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJMAL",
        "first_name": "ADNAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301104590",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "50594",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301104590",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "55957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110091667A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.