NPIMap

Individual provider Active NPI

Iftikhar Ali, MD

  • Internal Medicine Physician
  • Joplin, MO
National Provider Identifier
1700813607
Registry record updated Aug 15, 2023
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Dec 20, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2001007751 Issued in MO
Practice address
2705 S Range Line Rd Ste a
Joplin, MO 64804-3283
Phone
(417) 553-4252
NPI assigned
Jun 27, 2006
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 2001007751 MO Primary

Addresses

Primary practice location

2705 S Range Line Rd Ste a
Joplin, MO 64804-3283

Mailing address

2705 S Range Line Rd Ste a
Joplin, MO 64804-3283
Phone (417) 553-4252

Other identifiers 7

IdentifierTypeStateIssuer
205269418MedicaidMO
P0116491OtherRR MEDICARE
100199760AMedicaidOK
170944OtherANTHEM
100413450BMedicaidKS
100413450DMedicaidKS
P00187608OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001007751MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Medical, LLC Internal Medicine CurrentSince Oct 2, 2022 Accepting new patients
Phoenix Home Care, LLC Past Accepting new patients
NHC Healthcare-Joplin LLC Past Accepting new patients
Midwest Internal Medicine, PC Internal Medicine Past Accepting new patients

Locations

2613 S Main St
Ste D
Joplin, MO 64804
Phone (417) 553-7920

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1700813607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 S RANGE LINE RD STE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043283",
            "telephone_number": "417-553-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 S RANGE LINE RD STE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043283",
            "telephone_number": "417-553-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "IFTIKHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2001007751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205269418",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P0116491",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100199760A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "170944",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100413450B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100413450D",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00187608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.