NPIMap

Individual provider Active NPI

Marina Iskandir, MD

  • Interventional Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1487069811
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
T2400 Issued in TX
Practice address
150 55TH St
3-03
Brooklyn, NY 11220-2508
Phone
(718) 630-6373
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X T2400 TX Primary

Addresses

Primary practice location

150 55TH St
3-03
Brooklyn, NY 11220-2508

Mailing address

66 Rockwell PL Apt 19F
Brooklyn, NY 11217-1170
Phone (718) 709-1183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211013002758 TX Practitioner - Interventional Cardiology 1456759919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

3514 21St St
Lubbock, TX 79410-1210
Phone (806) 792-5105

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Multi-Specialty CurrentSince Jun 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Aug 4, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Multi-Specialty Current Accepting new patients
Covenant Medical Group Multi-Specialty CurrentSince Jun 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Multi-Specialty CurrentSince Aug 4, 2021 Accepting new patients

Locations

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

4004 82nd St
Ste 100
Lubbock, TX 79423
Phone (806) 722-3122

3514 21st St
Lubbock, TX 79410
Phone (806) 725-1801

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1487069811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 ROCKWELL PL APT 19F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171170",
            "telephone_number": "718-709-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "3-03",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKANDIR",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "T2400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.