NPIMap

Individual provider Active NPI

Semi Ayub, M.D

  • Rheumatology Physician
  • Saint Croix Falls, WI
National Provider Identifier
1487825071
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
55184 Issued in WI
Practice address
235 E State St
Saint Croix Falls, WI 54024-4117
Phone
(715) 483-3221
Fax
(715) 483-0507
NPI assigned
Mar 21, 2008
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 53857 MN
Rheumatology Physician 207RR0500X 55184 WI Primary

Addresses

Primary practice location

235 E State St
Saint Croix Falls, WI 54024-4117

Mailing address

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

Other practice location 1

2855 Campus Dr Ste 400
Plymouth, MN 55441-2659
Phone (763) 577-7400

Other identifiers 2

IdentifierTypeStateIssuer
1487825071MedicaidMN
1487825071MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sayub178377@excellian.direct.allina.com Direct
Direct Messaging Address sayub178377@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150615000348 MN Practitioner - Rheumatology 7810174430 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

12375 Lindstrom LN
Lindstrom, MN 55045-9551
Phone (651) 400-2240

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Rheumatology CurrentSince Mar 1, 2021 Accepting new patients
Allina Health System CurrentSince Mar 1, 2021 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2855 Campus Dr
Ste 400
Plymouth, MN 55441
Phone (612) 577-7400

Interoperability endpoints

  • Direct secure messaging: sayub178377@excellian.direct.allina.com

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1487825071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2855 Campus Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554412659",
            "country_code": "US",
            "telephone_number": "763-577-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYUB",
        "first_name": "SEMI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "53857",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "55184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487825071",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487825071",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sayub178377@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "235 E State St",
            "city": "Saint Croix Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540244117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sayub178377@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2855 Campus Dr Ste 400",
            "city": "Plymouth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554412659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Croix Falls, WI

Sources for this page

Verify at the official NPI Registry.