Individual provider Active NPI

Momin Nasir, BS

  • General Practice Physician
  • Iowa City, IA
National Provider Identifier
1366181802
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036.179204 Issued in IL
Practice address
300 Newton Road
Room 1216 Merf
Iowa City, IA 52242
Phone
(319) 335-2587
NPI assigned
Jun 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 036.179204 IL Primary

Addresses

Primary practice location

300 Newton Road
Room 1216 Merf
Iowa City, IA 52242

Mailing address

300 Newton Road
Room 1216 Merf
Iowa City, IA 52242
Phone (309) 335-5041

Other practice location 1

3112 Buckingham Rd
Galesburg, IL 61401-9588
Phone (309) 335-5041

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Epic

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230629003475 KS Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic SurgeryPractitioner - Emergency Medicine 1254790892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
036.179204ILMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1366181802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NEWTON ROAD",
            "address_2": "ROOM 1216 MERF",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "309-335-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NEWTON ROAD",
            "address_2": "ROOM 1216 MERF",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-335-2587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3112 Buckingham Rd",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614019588",
            "country_code": "US",
            "telephone_number": "309-335-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASIR",
        "first_name": "MOMIN",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-02",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.179204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "Secure Web",
            "address_1": "300 Newton Road",
            "address_2": "Room 1216 MERF",
            "city": "Iowa City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "52242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.