NPIMap

Individual provider Active NPI

Mohamed Shtiwi Ayan, MBBCH, MD

  • Interventional Cardiology Physician
  • Lexington, KY
National Provider Identifier
1700219193
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
58162 Issued in KY
Practice address
1401 Harrodsburg Rd
Lexington, KY 40504-3751
Phone
(859) 276-4429
Fax
(859) 276-5919
NPI assigned
Aug 20, 2013
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7023 NE
Internal Medicine Physician 207R00000X 58162 KY
Cardiovascular Disease Physician 207RC0000X 58162 KY
Interventional Cardiology Physician 207RI0011X 32620 NE
Interventional Cardiology Physician 207RI0011X 58162 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd
Lexington, KY 40504-3751

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other practice location 1

7440 S 91st St
Lincoln, NE 68526-9797
Phone (402) 489-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230911004020 KY Practitioner - Interventional Cardiology 4385936046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 Harrodsburg Rd
Suite A300
Lexington, KY 40504-3787
Phone (859) 276-4429

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting26
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7023NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentuckyone Health Medical Group, Inc. Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Kentuckyone Health Medical Group, Inc. Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
The Physician Network Internal Medicine PastSince Sep 1, 2011 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Lexington, KY 40504
Phone (859) 258-6784

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

Interoperability endpoints

  • Direct secure messaging: mayan345011@direct.stlukeshealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1700219193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-276-4429",
            "fax_number": "859-276-5919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7440 S 91st St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685269797",
            "country_code": "US",
            "telephone_number": "402-489-6555",
            "fax_number": "402-328-3770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYAN",
        "first_name": "MOHAMED",
        "middle_name": "SHTIWI",
        "credential": "MBBCH, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "7023",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "58162",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "58162",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NE",
            "license": "32620",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "58162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.