Individual provider Active NPI

James L Izanec, MD

  • Specialist
  • Haddon Heights, NJ
National Provider Identifier
1235356148
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA08234700 Issued in NJ
Practice address
217 White Horse Pike
Haddon Heights, NJ 08035-1703
Phone
(856) 547-1661
Fax
(856) 547-6117
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA08234700 NJ Primary

Addresses

Primary practice location

217 White Horse Pike
Haddon Heights, NJ 08035-1703

Mailing address

217 White Horse Pike
Haddon Heights, NJ 08035-1703
Phone (856) 547-1661

Other identifiers 1

IdentifierTypeStateIssuer
0133655MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08234700NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1235356148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 WHITE HORSE PIKE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351703",
            "telephone_number": "856-547-1661",
            "fax_number": "856-547-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 WHITE HORSE PIKE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351703",
            "telephone_number": "856-547-1661",
            "fax_number": "856-547-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZANEC",
        "first_name": "JAMES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA08234700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133655",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddon Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.