NPIMap

Individual provider Active NPI

Zulfiqar Ali Mirza, MD

  • Cardiovascular Disease Physician
  • Lebanon, IN
National Provider Identifier
1518021773
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01063791A Issued in IN
Practice address
2705 N Lebanon St Ste 342
Lebanon, IN 46052-8621
Phone
(765) 485-8740
Fax
(765) 485-8749
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01063791A IN Primary
Interventional Cardiology Physician 207RI0011X 01063791A IN

Addresses

Primary practice location

2705 N Lebanon St Ste 342
Lebanon, IN 46052-8621

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other identifiers 1

IdentifierTypeStateIssuer
200884320MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zmirza@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SC, CA, UT4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20070828001031 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 7315039864 Reassigns benefits to 3 organizations
I20210120003108 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7315039864 Reassigns benefits to 2 organizations
I20240614001675 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 7315039864
I20240617001916 UT Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 7315039864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Impact Physician Group Cardiology LLCGroup PAC ID 5799199816, 3 clinicians
Impact Physician Group Indiana LLCGroup PAC ID 6608111026, 25 clinicians
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

1260 City Ctr Dr
Carmel, IN 46032-3810
Phone (463) 333-9110

13219 N Meridian St
Carmel, IN 46032-5480
Phone (847) 821-6828

20 Pinnacle Pkwy
Elgin, SC 29045-8389
Phone (803) 438-8890

2505 N Lebanon St
Lebanon, IN 46052-8613
Phone (765) 485-8830

2605 N Lebanon St
Lebanon, IN 46052-1476

2705 N Lebanon St
Lebanon, IN 46052-8621

3050 N Lintel Dr
Impact Physician Gro
Bloomington, IN 47404-8945
Phone (812) 336-2815

4807 Edison Lakes Pkwy
Mishawaka, IN 46545-1112
Phone (574) 243-7727

5825 Harrison Blvd
South Ogden, UT 84403-4316
Phone (801) 475-5254

6085 Heartland Dr
Zionsville, IN 46077-4433

950 Park E Blvd
Impact Physician Gro
Lafayette, IN 47905-0792
Phone (765) 447-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86502SCMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Jun 17, 2019 Accepting new patients
Impact Physician Group, South Carolina LLC CurrentSince Dec 10, 2025 Accepting new patients
Witham Memorial Hospital CurrentSince Jun 17, 2019 Accepting new patients
Reid Hospital & Health Care Services, Inc Past Accepting new patients
Impact Physician Group Pulmonary LLC Past Accepting new patients

Locations

21 Eastbrook Bnd
Ste 218
Peachtree Cty, GA 30269
Phone (260) 407-8007

2705 N Lebanon St
Ste 342
Lebanon, IN 46052
Phone (765) 485-8740

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

3085 Taylor Rd
Cayce, SC 29033
Phone (803) 258-8240

20 Pinnacle Pkwy
Elgin, SC 29045
Phone (260) 407-8007

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.

Hospital & facility affiliations 12

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1518021773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 342",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528621",
            "telephone_number": "765-485-8740",
            "fax_number": "765-485-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "ZULFIQAR",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01063791A",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01063791A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200884320",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zmirza@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 342",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460528621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.