Mahmoud Ali
Individual provider Active NPI Clinical Cardiac Electrophysiology Physician · Libertyville, IL
NPI 1366837635 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1366837635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Cardiac Electrophysiology Physician 207RC0001X
- License
- 036-167077 (IL)
- Practice address
- 900 Technology Way Ste 220
Libertyville, IL 60048-5364 - Phone
- (847) 367-7171
- Fax
- (847) 367-7177
- NPI assigned
- Apr 2, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Cardiac Electrophysiology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Advanced Healthcare, Inc.
Aurora Medical Group, Inc.
Practice addresses (Care Compare)
14555 W National Ave
Suite 160
New Berlin, WI 53151-4497
Phone (262) 827-2975
6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400
Hospital & facility affiliations
- Aurora St Lukes Medical Center
- Aurora Medical Center Kenosha
- West Allis Memorial Hospital
- Aurora Lakeland Medical Center
- Aurora Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 37 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, IL
- 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 |
|---|---|---|---|---|
| I20190626003140 | WI | Practitioner - Cardiac Electrophysiology |
5698077410 | Reassigns benefits to 4 organizations |
| I20240104001377 | IL | Practitioner - Cardiac Electrophysiology | 5698077410 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-167077 | IL | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beloit Health System, Inc | Current |
Accepting new patients | |
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Beloit Health System, Inc | Internal Medicine | Current |
Accepting new patients |
| Lakeshore Medical Clinic, LLC | Current |
Accepting new patients | |
| Beloit Health System Inc | Internal Medicine | Current | Accepting new patients |
| Lakeshore Medical Clinic LTD | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Internal Medicine | Current |
Accepting new patients |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Internal Medicine | Current |
Accepting new patients |
| Beloit Health System Inc | Past | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293
1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510
1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
10400 75th St
Ste 212
Kenosha, WI 53142
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244
945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800
2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
13250 Washington Ave
Fl 2
Mount Pleasant, WI 53177
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
14555 W National Ave
Ste 160
New Berlin, WI 53151
Phone (262) 827-2975
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 69397-20 | WI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 036-167077 | IL | Yes |
Addresses
Primary practice location
900 Technology Way Ste 220
Libertyville, IL 60048-5364
Mailing address
29373 Network PL
Chicago, IL 60673-5506
Phone (847) 390-5900
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mali199922@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Libertyville, IL
- Ala Dean Attar DMD PC
- Ala Dean Attar DMD PC
- Madelyn Grace Albers
- Aleksandra Glodek DMD PC
- Alicia L Alexander
- Mir M Ali
- Natasha M Ali
- Sarah Alkilany
- All Time Urgent and Medical Care LTD
- Peter Gerald Allegretti
All providers in Libertyville, IL · Clinical Cardiac Electrophysiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.