Individual provider Active NPI

Amjad Iqbal, M.D.

  • Cardiovascular Disease Physician
  • Canton, OH
National Provider Identifier
1942209168
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35-084880 Issued in OH
Practice address
4160 Holiday St NW
Canton, OH 44718-2532
Phone
(330) 491-8000
Fax
(330) 492-7289
NPI assigned
Jul 19, 2005
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35-084880 OH Primary

Addresses

Primary practice location

4160 Holiday St NW
Canton, OH 44718-2532

Mailing address

4160 Holiday St NW
Canton, OH 44718-2532
Phone (330) 491-8000

Other identifiers 1

IdentifierTypeStateIssuer
2544214MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050107000924 OH Practitioner - Cardiovascular Disease (Cardiology) 5597653261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Louisville School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4160 Holiday St NW
Canton, OH 44718-2532
Phone (330) 491-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-084880OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paramount Home Health Care Inc Current Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Jun 1, 2007 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Jun 1, 2007 Accepting new patients
Advanced Cardiovascular Center, Inc Cardiovascular Disease CurrentSince Jun 4, 2007 Accepting new patients
St John Cardiovascular Medicine Inc Cardiovascular Disease Past Accepting new patients

Locations

1401 S Arch Ave
Ste B
Alliance, OH 44601

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

4160 Holiday St NW
Canton, OH 44718
Phone (330) 491-8000

4240 Munson St NW
Ste B
Canton, OH 44718
Phone (330) 224-5069

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11532/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 3

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1942209168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-491-8000",
            "fax_number": "330-492-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182532",
            "telephone_number": "330-491-8000",
            "fax_number": "330-492-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "AMJAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-084880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2544214",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.