NPIMap

Individual provider Active NPI

Haitham Mazek, MD

  • Interventional Cardiology Physician
  • Fayetteville, NC
National Provider Identifier
1124374186
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2023-01104 Issued in NC
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-4327
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 2023-01104 NC Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Q7421 TX
Internal Medicine Physician 207R00000X Q7421 TX
Hospitalist Physician 208M00000X Q7421 TX

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

1217 Piping Plover CT
Fayetteville, NC 28306-3598
Phone (806) 686-7110

Other practice location 1

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 761-0878

Other practice location 2

3601 4th St
Ms 9410
Lubbock, TX 79430
Phone (806) 743-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161019000071 TX Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6204135494
I20241219004361 NC Practitioner - Internal Medicine 6204135494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Cardiology PAGroup PAC ID 5890878581, 2 clinicians

Practice addresses (Care Compare)

3505 Village Dr
Fayetteville, NC 28304-4553
Phone (910) 323-0065

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q7421TXMDGeriatric Medicine (Internal Medicine) Physician
2023-01104NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Cardiology, P.a. Interventional Cardiology CurrentSince Sep 27, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Covenant Medical Group Internal Medicine Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients
Lubbock County Hospital District Past Accepting new patients

Locations

3505 Village Dr
Fayetteville, NC 28304
Phone (910) 323-0065

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

3505 Village Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 323-0065

Interoperability endpoints

  • Direct secure messaging: hmazek80307@capefearvalley.direct-ci.com

Organizations & group practices 5

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1124374186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 PIPING PLOVER CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063598",
            "telephone_number": "806-686-7110",
            "fax_number": "910-615-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794153364",
            "country_code": "US",
            "telephone_number": "806-761-0878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 4th St",
            "address_2": "MS 9410",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "79430",
            "country_code": "US",
            "telephone_number": "806-743-3150",
            "fax_number": "806-743-2978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZEK",
        "first_name": "HAITHAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2023-01104",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "Q7421",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q7421",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "Q7421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.