NPIMap

Individual provider Active NPI

Michella Azar, M.D.

  • Internal Medicine Physician
  • Davenport, IA
National Provider Identifier
1922480201
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-51416 Issued in IA
Practice address
3200 W Kimberly Rd Ste 205
Davenport, IA 52806-3059
Phone
(563) 421-0100
NPI assigned
Jun 23, 2015
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 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 MD-51416 IA Primary

Addresses

Primary practice location

3200 W Kimberly Rd Ste 205
Davenport, IA 52806-3059

Mailing address

3200 W Kimberly Rd Ste 205
Davenport, IA 52806-3059
Phone (563) 421-0100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michella.azar@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230821003377 IA Practitioner - Internal Medicine 9234441346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

3200 W Kimberly Rd
Mercyone Genesis Davenport Health P
Davenport, IA 52806-3059
Phone (563) 421-0100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Apr 4, 2024 Accepting new patients
Genesis Health System Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients
Genesis Health System Internal Medicine CurrentSince Apr 4, 2024 Accepting new patients
Genesis Health System CurrentSince Aug 7, 2023 Accepting new patients
Genesis Health System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

3200 W Kimberly Rd
Davenport, IA 52806
Phone (563) 421-0010

3200 W Kimberly Rd
#P
Davenport, IA 52806
Phone (563) 421-0100

3200 W Kimberly Rd
Ste 205
Davenport, IA 52806
Phone (563) 421-0100

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1922480201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD STE 205",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W KIMBERLY RD STE 205",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063059",
            "telephone_number": "563-421-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAR",
        "first_name": "MICHELLA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-51416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michella.azar@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis health system direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3200 W Kimberly Rd Ste 205",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528063059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.