Individual provider Active NPI

Niveen Youssef Iskander, M.D.

  • Pediatrics Physician
  • Fayetteville, NC
National Provider Identifier
1639260482
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9600180 Issued in NC
Practice address
1606 Morganton Rd
Fayetteville, NC 28305-4738
Phone
(910) 484-3121
Fax
(910) 484-9027
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9600180 NC Primary

Addresses

Primary practice location

1606 Morganton Rd
Fayetteville, NC 28305-4738

Mailing address

PO Box 53127
Fayetteville, NC 28305-3127
Phone (910) 484-3121

Other identifiers 3

IdentifierTypeStateIssuer
45437OtherNCBLUE CROSS BLUE SHIELD
8945437MedicaidNC
0205727OtherNCCIGNA HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130130000029 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1850545724

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9600180NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Children'S Clinic, P.a. Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639260482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53127",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283053127",
            "telephone_number": "910-484-3121",
            "fax_number": "910-484-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054738",
            "telephone_number": "910-484-3121",
            "fax_number": "910-484-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKANDER",
        "first_name": "NIVEEN",
        "middle_name": "YOUSSEF",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9600180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "45437",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8945437",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "0205727",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.