Individual provider Active NPI

Muhammed Wasim Niazi, MD

  • Neurology Physician
  • Rockledge, FL
National Provider Identifier
1215911433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME58732 Issued in FL
Practice address
1910 Rockledge Blvd
Unit 101
Rockledge, FL 32955
Phone
(321) 636-8366
Fax
(321) 636-3985
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME58732 FL Primary

Addresses

Primary practice location

1910 Rockledge Blvd
Unit 101
Rockledge, FL 32955

Mailing address

1910 Rockledge Blvd
Unt 101
Rockledge, FL 32955
Phone (321) 636-8366

Other identifiers 5

IdentifierTypeStateIssuer
0500148OtherFLUNITED
4657556OtherFLAETNA
26705OtherFLBC BS
45249OtherFLBC BS GRP
5395693OtherFLAETNA GRP

Other names 1

  • Wasim Niazi Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070430000678 FL Practitioner - Neurology 6305942848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Longwood Ave
Rockledge, FL 32955-2827
Phone (321) 636-8366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME58732FLMDNeurology Physician

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215911433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROCKLEDGE BLVD",
            "address_2": "UNT 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-636-8366",
            "fax_number": "321-636-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROCKLEDGE BLVD",
            "address_2": "UNIT 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-636-8366",
            "fax_number": "321-636-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIAZI",
        "first_name": "MUHAMMED",
        "middle_name": "WASIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME58732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "0500148",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4657556",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "26705",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS GRP",
            "identifier": "45249",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GRP",
            "identifier": "5395693",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WASIM",
            "last_name": "NIAZI",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.