NPIMap

Individual provider Active NPI

Hamza Mohammad Khudir Altaie, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1972121564
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76410 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 863-4000
Fax
(763) 236-3026
NPI assigned
Jul 9, 2020
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Family Medicine Physician 207Q00000X 76410 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

1 University Of New Mexico # 116025
Albuquerque, NM 87131-0001
Phone (505) 272-5062

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address haltaie668253@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
I20240618002380 MN Practitioner - Family Practice 4587017181 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
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 Medicine

State licenses

LicenseStateTypeSpecialty
76410MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital Association CurrentSince Jul 1, 2025 Accepting new patients
St Joseph's Area Health Services CurrentSince Sep 15, 2025 Accepting new patients
Lake View Memorial Hospital, Inc Current Accepting new patients
St. Joseph's Area Health Services Current Accepting new patients
Mille Lacs Health System CurrentSince Feb 14, 2025 Accepting new patients
Allina Health System Current Accepting new patients
Aitkin Community Hospital, Inc. CurrentSince May 20, 2025 Accepting new patients
Allina Health System CurrentSince Aug 5, 2024 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Lifecare Medical Center Current Accepting new patients
Mille Lacs Health System CurrentSince Feb 14, 2025 Accepting new patients
Lake View Memorial Hospital, Inc. Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Aitkin Community Hospital, Inc. CurrentSince May 20, 2025 Accepting new patients
Allina Health System CurrentSince Aug 5, 2024 Accepting new patients
Lake View Memorial Hospital, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Allina Health System Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3314 Solutions Ctr
Chicago, IL 60677

200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

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

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

600 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-3311

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Organizations & group practices 16

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 16

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1972121564",
    "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": "1 University Of New Mexico # 116025",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-5062",
            "fax_number": "505-272-6503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTAIE",
        "first_name": "HAMZA",
        "middle_name": "MOHAMMAD KHUDIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "76410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "haltaie668253@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.