NPIMap

Individual provider Active NPI

Azra Niaz, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Ballwin, MO
National Provider Identifier
1992155105
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2023035704 Issued in MO
Practice address
15421 Clayton Rd Ste 202
Ballwin, MO 63011-3161
Phone
(419) 383-4480
NPI assigned
Jun 18, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph Hospital 197 clinicians
Ste Genevieve County Memorial Hospital 74 clinicians

Practice addresses (Care Compare)

15421 Clayton Rd
Suite 202
Ballwin, MO 63011-3161
Phone (636) 534-1466

360 Broadway
Bangor, ME 04401-3979

753 Pointe Basse Dr
Ste Genevieve, MO 63670-1820
Phone (573) 883-2782

900 Broadway
Bangor, ME 04401-1900
Phone (207) 907-3777

Hospital & facility affiliations

  • Ste Genevieve County Memorial Hospital Hospital, Sainte Genevieve, MO, CCN 261330
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001
  • Parkland Health Center Hospital, Farmington, MO, CCN 260163
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO, ME3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20221028002637 AZ Practitioner - Endocrinology 8527390079 Reassigns benefits to 1 organization
I20231209000237 MO Practitioner - Endocrinology 8527390079 Reassigns benefits to 3 organizations
I20250212002593 ME Practitioner - Endocrinology 8527390079 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351028169MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Heart and Vascular Center PLLC CurrentSince Sep 15, 2022 Accepting new patients
St. Joseph Hospital CurrentSince Feb 1, 2025 Accepting new patients
Great Plains Endocrinology & Diabetes Care Endocrinology, Diabetes & Metabolism CurrentSince Nov 1, 2023 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
Ste. Genevieve County Memorial Hospital CurrentSince Jul 1, 2024 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Jul 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2849 Maricopa Ave
Lake Havasu City, AZ 86406

2082 Mesquite Ave
Ste 100A
Lk Havasu Cty, AZ 86403
Phone (928) 453-2828

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

900 Broadway
Bldg 1
Bangor, ME 04401
Phone (207) 907-1187

15421 Clayton Rd
Ste 202
Ballwin, MO 63011
Phone (419) 383-4480

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131
Phone (314) 270-1796

800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571

753 Pointe Basse Dr
Ste Genevieve, MO 63670
Phone (573) 883-2782

3000 Arlington Ave
#1150
Toledo, OH 43614
Phone (419) 383-4480

Interoperability endpoints

  • Direct secure messaging: inz4493@yourcarecommunity.org
  • Direct secure messaging: aniaz2782730@direct.bsmhealth.org
  • Direct secure messaging: azra.niaz.1@30348.direct.athenahealth.com
  • Direct secure messaging: azraniaz@mhccaremail.com
  • Direct secure messaging: aniaz19618@direct.utoledo.edu
  • FHIR API: https://api.platform.athenahealth.com/3291/brand/1/csg/1/fhir/r4

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351028169 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2023035704 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

15421 Clayton Rd Ste 202
Ballwin, MO 63011-3161

Mailing address

3000 Arlington Ave # Ms 1150
Toledo, OH 43614-2595

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1992155105MedicaidMI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 20, 2023.

{
    "created_epoch": "1466208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1992155105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE # MS 1150",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15421 CLAYTON RD STE 202",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113161",
            "telephone_number": "419-383-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIAZ",
        "first_name": "AZRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-18",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351028169",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MO",
            "license": "2023035704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992155105",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

Verify at the official NPI Registry.