Individual provider Active NPI

Nisarfathima Kazimuddin, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Bowling Green, KY
National Provider Identifier
1124028006
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
36859 Issued in KY
Practice address
421 US 31W Bypass
Bowling Green, KY 42101
Phone
(270) 785-0151
Fax
(270) 715-4722
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 36859 KY Primary

Addresses

Primary practice location

421 US 31W Bypass
Bowling Green, KY 42101

Mailing address

421 US 31W Bypass
Bowling Green, KY 42101
Phone (270) 785-0151

Other identifiers 1

IdentifierTypeStateIssuer
64044639MedicaidKY

Other names 1

  • Nisarfathima Abdulwaheed Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100217000184 KY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3678617446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Health Corporation, Inc.Group PAC ID 5496667628, 268 clinicians

Practice addresses (Care Compare)

421 US 31W Byp
Bowling Green, KY 42101-1775
Phone (270) 782-0151

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013
  • The Medical Center at Scottsville Hospital, Scottsville, KY, CCN 181324
  • The Medical Center at Franklin Hospital, Franklin, KY, CCN 181318
  • The Medical Center at Russellville Hospital, Russellville, KY, CCN 180066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince May 25, 2024 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince May 25, 2024 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421

421 US 31W Byp
Bowling Green, KY 42101
Phone (270) 782-7768

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

350 Park St
Ste 106
Bowling Green, KY 42101
Phone (270) 721-7265

825 2nd Ave
Ste B1
Bowling Green, KY 42101
Phone (270) 843-8600

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1124028006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 US 31W BYPASS",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-785-0151",
            "fax_number": "270-715-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 US 31W BYPASS",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-785-0151",
            "fax_number": "270-715-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIMUDDIN",
        "first_name": "NISARFATHIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "KY",
            "license": "36859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64044639",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NISARFATHIMA",
            "last_name": "ABDULWAHEED",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.