Mika Iwano, M.D.

Primary specialty

Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X

License

57098 Issued in AZ

Practice address

1001 Main St FL 5
Buffalo, NY 14203-1009

Phone

(716) 323-0220

NPI assigned

Jun 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mika Ito Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: miwano209210@direct.valleywisehealth.org
• Direct secure messaging: mikaito@mai.allscriptsdirect.net

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339

  Pediatric Emergency Medicine

  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1043573017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5461",
            "fax_number": "602-344-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850168034",
            "country_code": "US",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWANO",
        "first_name": "MIKA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-24",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "57098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKA",
            "last_name": "ITO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Iten, ANP, MS, RN, BSN
• Cesar Roberto Iturriaga, DO
• Elena Ivan, M.D.
• Nathaniel Mark Ivanick, MD
• Veronica Ivey
• Mildred Iyasere
• Renuka V Iyer, MD
• Jason Iype, PHARM D
• Odeyuwa Izekor, MD
• Joseph Izzo, MD

• Pediatric Emergency Medicine (Emergency Medicine) Physician in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Pediatric Emergency Medicine (Emergency Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.