Azra J Ali, M.D.
Individual provider Active NPI Family Medicine Physician · Peabody, MA
NPI 1255370243 · NPPES record last updated Mar 7, 2013
Key facts
- NPI
- 1255370243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 153455 (MA)
- Practice address
- 89 Foster St
Peabody, MA 01960-8925 - Phone
- (978) 532-4903
- Fax
- (978) 532-4995
- NPI assigned
- Jun 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160624000275 | MA | Practitioner - Family Practice | 1658518048 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 153455 | MA | Yes |
Addresses
Primary practice location
89 Foster St
Peabody, MA 01960-8925
Mailing address
89 Foster St
Peabody, MA 01960-8925
Phone (978) 532-4903
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153455 | Other | MA | TUFTS |
| J19702 | Other | MA | BCBS OF MA |
| 710534 | Other | MA | HARVARD PILGRIM |
| 1320912 | Medicaid | MA |
Other providers in Peabody, MA
- Emmanuel Darko Akoto
- Alain a. Chaoui MD PC
- Alan J Rubin Inc
- Hannah Rose Albee
- David Matthew Alden-St.Pierre
- All in a Touch Commercial & Residential Cleaning
- Gina Laurie Allen
- Lindsay Allen
- Alliance Health of Massachusetts Inc
- Allied Care LLC
All providers in Peabody, MA · Family Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.