Individual provider Active NPI

Mahwish Iqbal, MD

  • Family Medicine Physician
  • Syracuse, NY
National Provider Identifier
1154900470
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
331553 Issued in NY
Practice address
739 Irving Ave Ste 200
Syracuse, NY 13210-1668
Phone
(315) 479-5070
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 331553 NY Primary

Addresses

Primary practice location

739 Irving Ave Ste 200
Syracuse, NY 13210-1668

Mailing address

1001 W Fayette St Ste 400
Syracuse, NY 13204-2866
Phone (315) 937-3433

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address miqbal@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241004002121 NY Practitioner - Family Practice 4587195243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians
Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

736 Irving Ave
Syracuse, NY 13210-1687
Phone (315) 470-7111

739 Irving Ave
Syracuse, NY 13210-1651

739 Irving Ave
Suite 200
Syracuse, NY 13210-1668
Phone (315) 479-5070

739 Irving Ave
Suite 500
Syracuse, NY 13210-1664
Phone (315) 470-7409

Hospital & facility affiliations

  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331553NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crouse Medical Practice, PLLC CurrentSince Oct 7, 2024 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Oct 7, 2024 Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

739 Irving Ave
Ste 200300
Syracuse, NY 13210
Phone (315) 479-5070

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

739 Irving Ave
Ste 200
Syracuse, NY 13210
Phone (315) 479-5070

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 1

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1154900470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042866",
            "telephone_number": "315-937-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE STE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101668",
            "telephone_number": "315-479-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "MAHWISH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "331553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "miqbal@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "miqbal@crousemed.medentdirect.com",
            "address_1": "739 Irving Ave Ste 200",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.