Individual provider Active NPI

Qamaruddin Qazi, MD

  • Nephrology Physician
  • Green Bay, WI
National Provider Identifier
1700803541
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
38877 Issued in WI
Practice address
2845 Greenbrier Rd
1St Floor
Green Bay, WI 54311-6519
Phone
(920) 288-8100
NPI assigned
Jul 17, 2006
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 38877 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
1St Floor
Green Bay, WI 54311-6519

Mailing address

3720 Deer Run CT
Manitowoc, WI 54220-1668
Phone (920) 684-8939

Other identifiers 1

IdentifierTypeStateIssuer
32388000MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address qqazi57692@direct.myadvocateaurora.org

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
I20050516000986 WI Practitioner - Nephrology 3476594888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

5300 Memorial Dr
Two Rivers, WI 54241-3923
Phone (920) 793-7300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Baycare Aurora, LLC CurrentSince Jun 5, 2017 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2002 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2002 Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

2845 Greenbrier Rd
Ste 430
Green Bay, WI 54311

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

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

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

4100 Dewey St
Manitowoc, WI 54220
Phone (920) 686-5700

601 Reed Ave
Manitowoc, WI 54220
Phone (920) 682-8841

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

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

5300 Memorial Dr
Ste 303
Two Rivers, WI 54241
Phone (920) 793-6550

Interoperability endpoints

  • Direct secure messaging: qqazi57692@direct.myadvocateaurora.org

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 8

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1700803541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 DEER RUN CT",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542201668",
            "telephone_number": "920-684-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "address_2": "1ST FLOOR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAZI",
        "first_name": "QAMARUDDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "38877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32388000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "address_2": "1st Floor",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "qqazi57692@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "address_2": "1st Floor",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.