Individual provider Active NPI

Wasie Jawed Iqbal, M.D.

  • Hospitalist Physician
  • Prosper, TX
National Provider Identifier
1407275274
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
T1107 Issued in TX
Practice address
4100 W University Dr
Prosper, TX 75078-3123
Phone
(945) 204-4100
Fax
(682) 885-1903
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA10093800 NJ
Hospitalist Physician 208M00000X T1107 TX Primary

Addresses

Primary practice location

4100 W University Dr
Prosper, TX 75078-3123

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wiqbal213365@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170829003061 NJ Practitioner - Pediatric Medicine 5193044717 Reassigns benefits to 2 organizations
I20240502001833 TX Practitioner - Pediatric Medicine 5193044717 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10093800NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children's Physician Network Pediatrics CurrentSince Jun 17, 2024 Accepting new patients
Cook Children's Physician Network Pediatrics Current Accepting new patients
Atlantic Emergency Physician Team Pediatric Associates, P.C. CurrentSince Jul 1, 2017 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Jun 17, 2024 Accepting new patients
Nemours New Jersey Physician Practice, P.C. Pediatrics CurrentSince Dec 15, 2021 Accepting new patients
Cook Children's Medical Center Past Accepting new patients
Cook Childrens Medical Center - Prosper Past Accepting new patients

Locations

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

1280 Almonesson Rd
Woodbury, NJ 08096
Phone (856) 345-1401

7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: wiqbal213365@cookchildrens.direct-ci.com

Organizations & group practices 7

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1407275274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783123",
            "telephone_number": "945-204-4100",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "WASIE",
        "middle_name": "JAWED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10093800",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "T1107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wiqbal213365@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4100 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750783123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.