Individual provider Active NPI

Minoudokht Azimi-Zavarei, MD

  • Internal Medicine Physician
  • Brookfield, WI
National Provider Identifier
1649280827
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43879-20 Issued in WI
Practice address
1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone
(262) 798-8750
NPI assigned
Aug 9, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 43879-20 WI Primary

Addresses

Primary practice location

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060

Mailing address

1350 S Sunny Slope Rd
Brookfield, WI 53005-7060
Phone (262) 798-8750

Other practice location 1

11211 W Lincoln Ave
West Allis, WI 53227-1035
Phone (414) 454-8300

Other identifiers 1

IdentifierTypeStateIssuer
34389100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040520000350 WI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2163413014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11211 W Lincoln Ave
West Allis, WI 53227-1035
Phone (414) 454-8300

1155 N Mayfair Rd
Wauwatosa, WI 53226-3462
Phone (414) 955-5990

W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43879-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Nov 17, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine CurrentSince Nov 17, 2023 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine Current Accepting new patients

Locations

1350 S Sunny Slope Rd
Brookfield, WI 53005
Phone (262) 798-8750

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

2845 Greenbrier Rd
#1
Green Bay, WI 54311
Phone (920) 288-8100

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

11211 W Lincoln Ave
West Allis, WI 53227
Phone (414) 454-8300

Interoperability endpoints

  • Direct secure messaging: mazimizavarei150687@direct.froedtert.com

Organizations & group practices 3

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 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1649280827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "262-798-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S SUNNY SLOPE RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530057060",
            "telephone_number": "262-798-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11211 W Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532271035",
            "country_code": "US",
            "telephone_number": "414-454-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZIMI-ZAVAREI",
        "first_name": "MINOUDOKHT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43879-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34389100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.