Laily Mahoozi, M.D.
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Cordova, AK
NPI 1700868940 · NPPES record last updated Mar 18, 2024
Key facts
- NPI
- 1700868940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 002468 (NY)
- Practice address
- 705 Second St
Cordova, AK 99574-2290 - Phone
- (907) 424-3622
- Fax
- (907) 424-3275
- NPI assigned
- Nov 15, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231221000978 | TX | Practitioner - Endocrinology | 4789604810 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002468 | NY | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Native Village of Eyak | Current |
Accepting new patients | |
| Native Village of Eyak | Current |
Accepting new patients |
Interoperability endpoints
- lmahoozi@direct.eyak-nsn.gov
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 002468 | NY | Yes |
Addresses
Primary practice location
705 Second St
Cordova, AK 99574-2290
Mailing address
C/O Ilanka Community Health Center
PO Box 2290
Cordova, AK 99574-2290
Phone (907) 424-3622
Other providers in Cordova, AK
- Elizabeth King
- Michelle Dockins Kocan
- Madeline Karrie Ladd
- Heidi Rose Landeen
- Shannon Lindow
- Michelle Nikole Maxwell
- Olivia Moreno
- Karen Lee Morrissette
- Native Village of Eyak
- Native Village of Eyak
All providers in Cordova, AK · Endocrinology, Diabetes & Metabolism Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.