NPIMap

Individual provider Active NPI

Ayeza Jamil, DO

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1942888375
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
76806 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 863-4000
Fax
(763) 236-3026
NPI assigned
Mar 29, 2021
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036169096 IL
Hospitalist Physician 208M00000X 036169096 IL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 76806 MN Primary

Addresses

Primary practice location

2925 Chicago Ave
Minneapolis, MN 55407-1321

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

875 S. Route 31
Mercy Crystal Lake
Crystal Lake, IL 60114-8190
Phone (779) 220-5500

Other practice location 2

5970 Churchview Dr
Rockford, IL 61107-2574
Phone (612) 747-1532

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajamil663263@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240705001360 MN Practitioner - Internal Medicine 5496299174 Reassigns benefits to 1 organization
I20240814003348 IL Practitioner - HospitalistPractitioner - Internal Medicine 5496299174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
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 (651) 262-7633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76806MNMDInternal Medicine Physician
036169096ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jul 1, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 19, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 2, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 2, 2024 Accepting new patients
Allina Health System CurrentSince Aug 19, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

2300 N Rockton Ave
Rockford, IL 61103

5970 Churchview Dr
Rockford, IL 61107
Phone (815) 971-8990

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

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

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

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

Interoperability endpoints

  • Direct secure messaging: ajamil663263@excellian.direct.allina.com

Organizations & group practices 7

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 8

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1942888375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "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": [
        {
            "address_1": "875 S. Route 31",
            "address_2": "Mercy Crystal Lake",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "601148190",
            "country_code": "US",
            "telephone_number": "779-220-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5970 Churchview Dr",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611072574",
            "country_code": "US",
            "telephone_number": "612-747-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMIL",
        "first_name": "AYEZA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036169096",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036169096",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "76806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajamil663263@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.