Individual provider Active NPI

Akil Moinuddin II, M.D

  • Internal Medicine Physician
  • Aurora, IL
National Provider Identifier
1548292683
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086879 Issued in IL
Practice address
302 E New York St
Aurora, IL 60505-3424
Phone
(630) 844-0080
Fax
(630) 801-6967
NPI assigned
Jul 7, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036086879 IL Primary

Addresses

Primary practice location

302 E New York St
Aurora, IL 60505-3424

Mailing address

302 E New York St
Aurora, IL 60505-3424
Phone (630) 844-0080

Other identifiers 4

IdentifierTypeStateIssuer
14D0940581OtherILCLIA
036086879MedicaidIL
110075398OtherILRAILROAD MEDICARE
10592526OtherILCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20041203000066 IL Practitioner - Internal Medicine 3870558380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

302 E New York St
Aurora, IL 60505-3424
Phone (630) 844-0080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086879ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Akil Moinuddin MD Inc Internal Medicine CurrentSince Aug 9, 1993 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

302 E New York St
Aurora, IL 60505
Phone (630) 844-0080

Organizations & group practices 4

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548292683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053424",
            "telephone_number": "630-844-0080",
            "fax_number": "630-801-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E NEW YORK ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053424",
            "telephone_number": "630-844-0080",
            "fax_number": "630-801-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOINUDDIN",
        "first_name": "AKIL",
        "name_suffix": "II",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0940581",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086879",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110075398",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10592526",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.