Individual provider Active NPI

Ilgizar Hart, MD

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1700523172
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL87648 Issued in SC
Practice address
2000 6TH Ave S
Birmingham, AL 35233-2110
Phone
(205) 934-9999
NPI assigned
May 17, 2022
Last updated
May 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 LL87648 SC Primary

Addresses

Primary practice location

2000 6TH Ave S
Birmingham, AL 35233-2110

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-2731

Other names 1

  • Ilgizar Khairutdinov Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20250605001160 AL Practitioner - Internal Medicine 5597133280 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL87648SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2025 Accepting new patients

Locations

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1700523172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332110",
            "telephone_number": "205-934-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258908",
            "country_code": "US",
            "telephone_number": "843-792-2731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "ILGIZAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-17",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL87648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILGIZAR",
            "last_name": "KHAIRUTDINOV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.