Ishtiaque Hossain Mohiuddin

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

200400922 Issued in NC

Practice address

2936 N Elm St Ste 102
Lumberton, NC 28358-2981

Phone

(910) 671-6619

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Ishtiaque H Mohiuddin Professional name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Regional Physician ServicesGroup PAC ID 7012058548, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Merit-based Incentive Payment System (MIPS)

Final score

88.44 of 100Reported as group

Quality

88.05

Promoting interoperability

98

Improvement activities

40

Cost

75.07

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1427282045
  Medicare reassignment Care Compare group NPD
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1265165518
  NPD
• Our Community Hospital, Inc

  • Skilled Nursing Facility
  • Scotland Neck, NC
  • NPI 1558391250
  NPD (past)
• Rex Hospital, Inc.

  • Nutrition Education Nutritionist
  • Raleigh, NC
  • NPI 1821472572
  NPD (past)

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

• Southeastern Regional Medical Center

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1114969433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490",
            "telephone_number": "984-215-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 N ELM ST STE 102",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582981",
            "telephone_number": "910-671-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHIUDDIN",
        "first_name": "ISHTIAQUE",
        "middle_name": "HOSSAIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "TP312",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A067466",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME108828",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200400922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137WJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISHTIAQUE",
            "last_name": "MOHIUDDIN",
            "middle_name": "H",
            "credential": "M.D., PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mission Foot and Ankle, PLLC
• Mission Home Healthcare, LLC
• Tiara Marque Mitchell, LCSW-A
• Victoria Brooke Mitchell
• Chiranj Nishith Modi, MD
• Fasil Ferris Mohomed, MD
• Yniquekeyah Mole
• Monarch
• Monarch
• Monarch

• Cardiovascular Disease Physician in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.
• 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.