NPIMap

Individual provider Active NPI

Ayaz Ahmad, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1629573142
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021031235 Issued in MO
Practice address
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone
(314) 996-5772
NPI assigned
Mar 27, 2018
Last updated
May 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 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 2021031235 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Saint Louis, MO 63131-2329

Mailing address

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772

Other practice location 1

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8778

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210913002806 MO Practitioner - Internal MedicinePractitioner - Hospitalist 3870999097 Reassigns benefits to 1 organization
I20230524001336 IN Practitioner - Internal Medicine 3870999097 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proactive Clinical Partners - AcoGroup PAC ID 5890154884, 30 clinicians
Proactive Clinical PartnersGroup PAC ID 8527315852, 32 clinicians

Practice addresses (Care Compare)

2485 Directors Row
Suite D
Indianapolis, IN 46241-4907
Phone (317) 941-7338

2494 N Lebanon St
Homewood of Lebanon
Lebanon, IN 46052-1111
Phone (317) 941-7338

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Jun 1, 2025 Accepting new patients
Physician Groups LC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Proactive Clinical Partners CurrentSince Apr 23, 2023 Accepting new patients
Physician Groups LC CurrentSince Oct 1, 2021 Accepting new patients
Proactive Clinical Partners - Aco CurrentSince Jun 24, 2023 Accepting new patients

Locations

1108 Kingwood Dr
Avon, IN 46123
Phone (317) 204-1100

950 N Lakeview Dr
Greensburg, IN 47240
Phone (812) 662-7778

2485 Directors Row
Ste D
Indianapolis, IN 46241
Phone (317) 941-7331

2494 N Lebanon St
Lebanon, IN 46052
Phone (765) 482-2076

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 430-3722

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

3009 N Ballas Rd
Ste 390C
Saint Louis, MO 63131
Phone (314) 996-3575

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

3844 S Lindbergh Blvd
Ste 235
Saint Louis, MO 63127
Phone (314) 525-0420

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Countryside MeadowsAvon, IN, CCN 155792 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 5, 2025
May 29, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 10

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1629573142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "314-996-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6420 Clayton Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171811",
            "country_code": "US",
            "telephone_number": "314-768-8778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "AYAZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021031235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.