DR. MOIZ EHTESHAM MD
NPI 1174140313
Internal Medicine - Cardiovascular Disease in Maywood, IL

Q: What is Moiz Ehtesham's NPI number?

The NPI number for Moiz Ehtesham is 1174140313. It was assigned to this individual provider in the NPPES registry on July 4, 2020.

Q: What is Moiz Ehtesham's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Moiz Ehtesham was last updated on May 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 04, 2020PECOS Enrolled

2160 S 1ST AVE, MAYWOOD, IL 60153(888) 584-7888 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 31, 2023, Jul 4, 2020 (2 updates tracked since 2020).

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About Dr. Moiz Ehtesham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MOIZ EHTESHAM MD (NPI 1174140313) is an individual cardiovascular disease provider in Maywood, Illinois, licensed in Illinois (036164899) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1174140313

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. MOIZ EHTESHAMCredential: MD

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address2160 S 1st AveMaywood, IL 60153-3328

Phone(888) 584-7888

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJuly 4, 2020

Last NPPES UpdateMay 31, 20232 updates tracked since enumeration

NPPES CertifiedMay 31, 2023

✔ NPI 1174140313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in IL · 036164899

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2160 S 1ST AVE, Maywood, IL 60153

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Moiz Ehtesham Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153782396

PECOS Enrollment IDI20260828001327

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Moiz Ehtesham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Maryland Community Medical Group, Inc.

616 mi

Family Medicine

821 N EUTAW ST
Baltimore, MD 21201

Reassigned Medicare billing, Maryland enrollment
966 clinicians in this Medicare group

NPI 1477530624 (443) 552-2900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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