Ijaz Mahmood, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

31150 Issued in KY

Practice address

1239 Woodland Dr
Suite 105
Elizabethtown, KY 42701-2770

Phone

(270) 900-1461

Fax

(270) 900-1468

NPI assigned

Nov 16, 2005

Last updated

May 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Guiding Lights PLC

  dba Lincoln Trail Adult Day care

  • Adult Day Care Clinic/Center
  • Radcliff, KY
  • NPI 1386184570
  Authorized official Same address or phone
• Ijaz Mahmood MD PLC

  • Hematology & Oncology Physician
  • Elizabethtown, KY
  • NPI 1225336852
  Authorized official Same address or phone

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1609858539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 WOODLAND DR",
            "address_2": "SUITE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012770",
            "telephone_number": "270-900-1461",
            "fax_number": "270-900-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 WOODLAND DR",
            "address_2": "SUITE 105",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012770",
            "telephone_number": "270-900-1461",
            "fax_number": "270-900-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "IJAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "31150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64311509",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1048927",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Vu Mabry
• Stephanie Brooke Mace, CADC
• Carla A Mackey, LMFT
• Charles Kenny Maffet, M.D.
• Mahendra M Patel MD PSC
• Main Dental PLLC
• Macgregor Main, DMD
• Megan Main, DMD
• Islam Makhlouf
• Theodore Jerome Malecek, RPH

• Hematology & Oncology Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Hematology & Oncology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.