Lara Hayel Al-Ejeilat, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

56470 Issued in MN

Practice address

14500 99TH Ave N
Maple Grove, MN 55369-4730

Phone

(763) 898-1000

Fax

(763) 898-1009

NPI assigned

Aug 24, 2010

Last updated

Dec 5, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lalejeilat300790@fairview.direct-ci.com

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Eden Prairie, MN
  • NPI 1710293402
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1679889042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 LINCOLN DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361009",
            "telephone_number": "352-871-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 99TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694730",
            "telephone_number": "763-898-1000",
            "fax_number": "763-898-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-EJEILAT",
        "first_name": "LARA",
        "middle_name": "HAYEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "56470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmina Ahmed, MD
• Olalekan Hakeem Akanbi, MD
• Anas Akhras, DMD
• Ayaa Al Mosawi
• Al Shifa Dentistry PA
• Jordan Lynn Alabase, LGSW
• Alb Dental Studio PLLC (Grove Dentist)
• Shawn Michael Alderman, MD
• Jennifer Alders
• Chelsea Alger, PTA

• Pediatrics Physician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.