Individual provider Active NPI

Ali Reza Esmaeilzadeh, MD

  • Family Medicine Physician
  • Maplewood, MN
National Provider Identifier
1790746394
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43644 Issued in MN
Practice address
2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242
Phone
(651) 232-7800
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43644 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Mailing address

2396 Arnold Palmer Dr
Blaine, MN 55449-5517
Phone (651) 343-3403

Other identifiers 1

IdentifierTypeStateIssuer
420058600MedicaidMN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050324000626 MN Practitioner - Family Practice 2466408265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1825 Woodwinds Dr
Woodbury, MN 55125-2202
Phone (651) 232-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43644MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 1, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 1, 2017 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

2945 Hazelwood St
Maplewood, MN 55109
Phone (651) 232-7800

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

2945 Hazelwood St
Ste 200
Saint Paul, MN 55109
Phone (612) 440-6315

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: aesmaeelzadeh503016@fairview.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1790746394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2396 ARNOLD PALMER DR",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495517",
            "telephone_number": "651-343-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESMAEILZADEH",
        "first_name": "ALI",
        "middle_name": "REZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "43644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420058600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.