Individual provider Active NPI

Izzah Vasim, M.D

  • Endocrinology, Diabetes & Metabolism Physician
  • Lexington, NC
National Provider Identifier
1568812485
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101286425 Issued in VA
Practice address
250 Hospital Dr
Lexington, NC 27292-6792
Phone
(336) 248-5161
Fax
(336) 716-0030
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0101286425 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 2019-02369 NC

Addresses

Primary practice location

250 Hospital Dr
Lexington, NC 27292-6792

Mailing address

1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2011

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-1825

Other practice location 2

1101 Sam Perry Blvd Ste 305
Fredericksburg, VA 22401-4465
Phone (540) 374-3290

Other identifiers 1

IdentifierTypeStateIssuer
1568812485OtherWAKE FOREST BAPTIST MEDICAL CENTRE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 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
I20210720001555 NC Practitioner - HospitalistPractitioner - Internal Medicine 4082986484 Reassigns benefits to 1 organization
I20250804003410 VA Practitioner - Endocrinology 4082986484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1101 Sam Perry Blvd
Suite 305
Fredericksburg, VA 22401-4465
Phone (540) 374-3290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101286425VAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Jul 28, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2021 Accepting new patients
Mary Washington Healthcare Physicians Endocrinology, Diabetes & Metabolism CurrentSince Jul 28, 2025 Accepting new patients

Locations

250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

1101 Sam Perry Blvd
Ste 305
Fredericksburg, VA 22401
Phone (540) 374-3290

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Interoperability endpoints

  • Direct secure messaging: ivasim138389@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 3

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 4

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1568812485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926792",
            "telephone_number": "336-248-5161",
            "fax_number": "336-716-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Sam Perry Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014465",
            "country_code": "US",
            "telephone_number": "540-374-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASIM",
        "first_name": "IZZAH",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101286425",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2019-02369",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAKE FOREST BAPTIST MEDICAL CENTRE",
            "identifier": "1568812485",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.