Maqbool B Ali, M.D

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036058850 Issued in IL

Practice address

4930 N Executive Dr
Peoria, IL 61614-4894

Phone

(309) 692-7575

Fax

(309) 692-0275

NPI assigned

Jan 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Syed Masood Ali, MDSC

  • General Practice Physician
  • Peoria, IL
  • NPI 1689896961
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1801874565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 N EXECUTIVE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144894",
            "telephone_number": "309-692-7575",
            "fax_number": "309-692-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 N EXECUTIVE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144894",
            "telephone_number": "309-692-7575",
            "fax_number": "309-692-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MAQBOOL",
        "middle_name": "B",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036058850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "212742",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Alfini, MD
• Yasmine Fawaz Alhajeh, MD
• Alaaedin Alhomosh, MD
• Atif Masood Ali, DPT
• Jennifer Ali
• Suzain Ali, MBBS, MPH
• Syed Masood Ali, M.D.
• Waqas Ali, MD
• All in Wellness, PLLC
• All Ways Caring Services, Inc.

• Surgery Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.