Individual provider Active NPI

Mazen Nashed, M.D.

  • Cardiovascular Disease Physician
  • Bridgeport, WV
National Provider Identifier
1124114574
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
WV19485A Issued in WV
Practice address
527 Medical Park Drive
Suite 204
Bridgeport, WV 26330
Phone
(304) 933-3800
Fax
(304) 933-3815
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X WV19485A WV Primary

Addresses

Primary practice location

527 Medical Park Drive
Suite 204
Bridgeport, WV 26330

Mailing address

527 Medical Park Drive
Suite 204
Bridgeport, WV 26330
Phone (304) 933-3800

Other identifiers 2

IdentifierTypeStateIssuer
0640002000MedicaidWV
000505915OtherWVBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100324000111 WV Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 4981739315 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
WV19485AWVMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. Cardiovascular Disease CurrentSince Jul 24, 1998 Accepting new patients
United Hospital Center Cardiovascular Disease CurrentSince Jul 24, 1998 Accepting new patients
Associated Specialists, Inc. CurrentSince Jul 13, 1998 Accepting new patients

Locations

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

527 Medical Park Dr
Ste 204
Bridgeport, WV 26330
Phone (304) 623-5711

1370 Johnson Ave
Ste 201
Bridgeport, WV 26330
Phone (681) 342-3730

200 Route 98 W St
Ste 107
Nutter Fort, WV 26301
Phone (304) 623-5711

Interoperability endpoints

  • Direct secure messaging: mazen.nashed@asidrs.directbygreenway.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1124114574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DRIVE",
            "address_2": "SUITE 204",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-3800",
            "fax_number": "304-933-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASHED",
        "first_name": "MAZEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WV",
            "license": "WV19485A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0640002000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000505915",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.