NPIMap

Individual provider Active NPI

Lyudmila Islyamova, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1821231168
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53707 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 863-4000
Fax
(763) 236-3026
NPI assigned
Apr 16, 2009
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 55199-020 WI
Internal Medicine Physician 207R00000X 53707 MN Primary

Addresses

Primary practice location

2925 Chicago Ave
Minneapolis, MN 55407-1321

Mailing address

2925 Chicago Ave # Mr 10860
Minneapolis, MN 55407-1321
Phone (612) 262-1166

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lislyamova554349@excellian.direct.allina.com Direct
Direct Messaging Address lislyamova554349@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130415000187 MN Practitioner - HospitalistPractitioner - Internal Medicine 4688851678 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55199-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Allina Health System Current Accepting new patients
Group Health Plan Inc CurrentSince Feb 17, 2013 Accepting new patients
Healtheast Medical Research Insititue Internal Medicine CurrentSince Apr 18, 2020 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Apr 18, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Apr 2, 2020 Accepting new patients
Group Health, Inc. Current Accepting new patients
Allina Health System CurrentSince Jun 1, 2021 Accepting new patients
Group Health, Inc. CurrentSince Feb 17, 2013 Accepting new patients
Allina Health System CurrentSince Jun 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Apr 2, 2020 Accepting new patients
Allina Health System Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10860
Minneapolis, MN 55407

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

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

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

640 Jackson St
#11109E
Saint Paul, MN 55101
Phone (651) 254-3456

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
Stillwater, MN 55082

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1821231168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE # MR 10860",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-863-4000",
            "fax_number": "763-236-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLYAMOVA",
        "first_name": "LYUDMILA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "55199-020",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lislyamova554349@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "640 Jackson St",
            "address_2": "MS 11109E",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551012502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lislyamova554349@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.