Individual provider Active NPI

Sumaiyya Aijaz Mohiuddin, MD

  • Student in an Organized Health Care Education/Training Program
  • Willmar, MN
National Provider Identifier
1437042587
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
502 2ND St SW
Willmar, MN 56201-3337
Phone
(320) 251-2700
Fax
(320) 231-8697
NPI assigned
May 29, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MN Primary

Addresses

Primary practice location

502 2ND St SW
Willmar, MN 56201-3337

Mailing address

502 2ND St SW
Willmar, MN 56201-3337
Phone (320) 251-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625002745 MN Order and Referring Only - Family PracticePractitioner - Family Practice 5496267346

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: smohiuddin871971@direct.centracare.com

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1437042587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 2ND ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013337",
            "telephone_number": "320-251-2700",
            "fax_number": "320-231-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 2ND ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013337",
            "telephone_number": "320-251-2700",
            "fax_number": "320-231-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHIUDDIN",
        "first_name": "SUMAIYYA",
        "middle_name": "AIJAZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.