NPIMap

Individual provider Active NPI

Ibraiz Iqbal, MD

  • Interventional Cardiology Physician
  • Somerset, KY
National Provider Identifier
1720067168
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
38636 Issued in KY
Practice address
104 Hardin LN
Suite B
Somerset, KY 42503-3800
Phone
(606) 677-1112
Fax
(606) 679-1341
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 38636 KY Primary

Addresses

Primary practice location

104 Hardin LN
Suite B
Somerset, KY 42503-3800

Mailing address

104 Hardin LN
Suite B
Somerset, KY 42503-3800
Phone (606) 677-1112

Other practice location 1

45 Moonbow Plz
Corbin, KY 40701-8949
Phone (606) 523-9010

Other identifiers 4

IdentifierTypeStateIssuer
000000336184OtherKYBCBS
64082605MedicaidKY
P00147774OtherKYPALMETTO GBA
000000336184OtherKYANTHEM BCBS

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
I20040804000998 KY Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional RadiologyPractitioner - Nuclear MedicinePractitioner - Peripheral Vascular Disease 8022089390 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine, Nuclear Medicine, Peripheral Vascular Disease
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1 Trillium Way
MTM/DSM
Corbin, KY 40701-8727
Phone (606) 526-4647

104 Hardin LN
Suite B
Somerset, KY 42503-3800
Phone (606) 677-1112

104 Hardin LN B
Somerset, KY 42503-3800

4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3094
Phone (859) 260-4390

613 23Rd St
Suite 230
Ashland, KY 41101-2868
Phone (606) 324-4745

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting21
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional Hospital LLC CurrentSince Jul 1, 2004 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Family Medicine CurrentSince Feb 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Lake Cumberland Regional Hospital LLC Family Medicine Current Accepting new patients
Lake Cumberland Regional Hospital LLC CurrentSince Jul 1, 2004 Accepting new patients
Heart Rehab Inc. Past Accepting new patients
Baptist Healthcare System, Inc Past Accepting new patients

Locations

45 Moonbow Plz
Corbin, KY 40701
Phone (606) 523-9010

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

350 Hospital Way
Ste 100
Somerset, KY 42503
Phone (606) 451-2600

Interoperability endpoints

  • Direct secure messaging: iqbalibraiz@arh.medalliesdirect.net
  • FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

Organizations & group practices 10

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 5

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1720067168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HARDIN LN",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033800",
            "telephone_number": "606-677-1112",
            "fax_number": "606-679-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HARDIN LN",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033800",
            "telephone_number": "606-677-1112",
            "fax_number": "606-679-1341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Moonbow Plz",
            "address_purpose": "LOCATION",
            "city": "Corbin",
            "state": "KY",
            "postal_code": "407018949",
            "country_code": "US",
            "telephone_number": "606-523-9010",
            "fax_number": "606-523-0028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "IBRAIZ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "38636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000336184",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082605",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00147774",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000336184",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.