Maryam Iftikhar

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4424 Issued in CT

Practice address

672 Silas Deane Hwy
Wethersfield, CT 06109-3053

Phone

(860) 967-3600

NPI assigned

Apr 10, 2019

Last updated

Apr 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mercy College, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: maryam.iftikhar@xdr.hhchealthdirect.org
• Direct secure messaging: miftikhar645819@direct.ynhh.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment
• Urgent Care Medical Associates, LLC

  • Urgent Care Clinic/Center
  • Brookfield, CT
  • NPI 1730479254
  Medicare reassignment
• WRK Ventures, LLC

  dba Urgent Care of Southbury

  • Urgent Care Clinic/Center
  • Southbury, CT
  • NPI 1194993980
  NPD (past)

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1215490891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 BOLDUC CT",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067163146",
            "telephone_number": "203-578-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093053",
            "telephone_number": "860-967-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFTIKHAR",
        "first_name": "MARYAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Mary Horan, NP
• Yifan Huang, PHARM.D
• Taylor Adah Humbert, LCSW
• Hannah Hurtenbach
• John Charles Huston, MD
• Integrated Procare Services
• Intercommunity Mental Health Group
• J & L Medical Services
• J Dental Group PC (Wethersfield Dental Associates)
• Joanne Jacques

• Physician Assistant in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.