NPIMap

Individual provider Active NPI

Fazal I Raziq, MD

  • Pulmonary Disease Physician
  • Green Bay, WI
National Provider Identifier
1265928915
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
82694-20 Issued in WI
Practice address
1821 S Webster Ave
Green Bay, WI 54301-2253
Phone
(920) 496-4700
NPI assigned
Jul 5, 2018
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 4301115856 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301504715 MI
Pulmonary Disease Physician 207RP1001X 4301504715 MI
Pulmonary Disease Physician 207RP1001X 82694-20 WI Primary

Addresses

Primary practice location

1821 S Webster Ave
Green Bay, WI 54301-2253

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
100276589MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fraziq408021@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240709003210 WI Practitioner - Pulmonary Disease 0143623520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301115856MIMDInternal Medicine Physician
4301504715MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince May 1, 2024 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Internal Medicine CurrentSince May 1, 2024 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Internal Medicine CurrentSince May 1, 2024 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince May 1, 2024 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Internal Medicine CurrentSince May 1, 2024 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince May 1, 2024 Accepting new patients

Locations

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: fraziq408021@ewd.direct.hshs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1265928915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZIQ",
        "first_name": "FAZAL",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301115856",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301504715",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301504715",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "82694-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100276589",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fraziq408021@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1821 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.