Organization Active NPI

Heart Center of Somerset PLLC

  • Cardiovascular Disease Physician
  • Somerset, KY
National Provider Identifier
1073592572
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
HEART CENTER OF SOMERSET PLLC
Practice address
104 Hardin LN
Suite B
Somerset, KY 42503-3800
Phone
(606) 677-1112
Fax
(606) 679-1341
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Ibraiz Iqbal, MDNPI 1720067168
Title
Physician
Phone
(606) 677-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

104 Hardin LN
Suite B
Somerset, KY 42503-3800

Mailing address

104 Hardin LN
Suite B
Somerset, KY 42503-3800
Phone (606) 677-1112

Other identifiers 4

IdentifierTypeStateIssuer
000000336184OtherKYBCBS
64082605MedicaidKY
1214392OtherKYCHA HEALTH
P00147774OtherKYPALMETTO GBA

Other names 1

  • The Heart Center of Somerset, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802001329 KY Part B Supplier - Clinic/Group Practice 6507837879 Receives reassigned benefits from 2 practitioners
Practice locations: Somerset, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D1034951Heart Center of Somerset, PLLC, the104 Hardin Lane, Suite B, Somerset, KY 42503Certificate of waiverDec 15, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1073592572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HARDIN LN",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033800",
            "telephone_number": "606-677-1112",
            "fax_number": "606-679-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HARDIN LN",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033800",
            "telephone_number": "606-677-1112",
            "fax_number": "606-679-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CENTER OF SOMERSET PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "IBRAIZ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "606-677-1112",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000336184",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082605",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA HEALTH",
            "identifier": "1214392",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00147774",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Heart Center of Somerset, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Heart Center of Somerset, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.