Organization Active NPI

Naeem Pervaiz, M.D., P.C.

  • Urology Physician
  • Princeton, WV
National Provider Identifier
1184757163
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NAEEM PERVAIZ, M.D., P.C.
Practice address
608 New Hope Rd Ste 1
Princeton, WV 24740-2287
Phone
(304) 425-1522
Fax
(304) 487-9447
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Authorized official

Name
Dr. Naeem Pervaiz, MDNPI 1952367666
Title
President
Phone
(304) 425-1522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

608 New Hope Rd Ste 1
Princeton, WV 24740-2287

Mailing address

608 New Hope Rd Ste 1
Princeton, WV 24740-2287
Phone (304) 425-1522

Other identifiers 2

IdentifierTypeStateIssuer
406343640OtherWVRAILROAD MEDICARE
0130715000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000462 WV Part B Supplier - Clinic/Group Practice 6507947546 Receives reassigned benefits from 1 practitioner
Practice locations: Princeton, WV

National Provider Directory

National Provider Directory

Locations

608 New Hope Rd
Ste 1
Princeton, WV 24740
Phone (304) 425-1522

200 New Hope Rd 1
Princeton, WV 24740
Phone (304) 425-1522

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1184757163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 NEW HOPE RD STE 1",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402287",
            "telephone_number": "304-425-1522",
            "fax_number": "304-487-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 NEW HOPE RD STE 1",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402287",
            "telephone_number": "304-425-1522",
            "fax_number": "304-487-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAEEM PERVAIZ, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "PERVAIZ",
        "authorized_official_first_name": "NAEEM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-425-1522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406343640",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130715000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.