Organization Active NPI

E Town Lung Specialist PSC

  • Medical Specialty Clinic/Center
  • Elizabethtown, KY
National Provider Identifier
1790797702
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
E TOWN LUNG SPECIALIST PSC
Practice address
914 N Dixie Ave
Elizabethtown, KY 42701-2520
Phone
(270) 735-9066
Fax
(270) 735-9036
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Aijaz A Yazdani, MDNPI 1447222781
Title
Medical Doctor
Phone
(270) 735-9066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

914 N Dixie Ave
Elizabethtown, KY 42701-2520

Mailing address

914 N Dixie Ave
Elizabethtown, KY 42701-2520
Phone (270) 735-9066

Other identifiers 2

IdentifierTypeStateIssuer
290014995OtherRAILROAD MEDICARE
64328784MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011000229 KY Part B Supplier - Clinic/Group Practice 6608891452 Receives reassigned benefits from 1 practitioner
Practice locations: Elizabethtown, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1790797702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-735-9066",
            "fax_number": "270-735-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-735-9066",
            "fax_number": "270-735-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E TOWN LUNG SPECIALIST PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "YAZDANI",
        "authorized_official_first_name": "AIJAZ",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "270-735-9066",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290014995",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64328784",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.