Active NPI
Nauman Nisar, MD
- Clinical Pathology/Laboratory Medicine Physician
- Ann Arbor, MI
National Provider Identifier
1962486530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- 54745
- Practice address
- 2215 Fuller Rd
Ann Arbor, MI 48105-2303 - Phone
- (734) 845-3427
- Fax
- (734) 845-3207
- NPI assigned
- Dec 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 54745 | KY | Primary |
Addresses
Primary practice location
2215 Fuller Rd
Ann Arbor, MI 48105-2303
Mailing address
PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-4387
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14S1J | Other | FL | BCBS |
| 003138169A | Medicaid | GA | |
| 009607400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54745 | KY | MD | Clinical Pathology/Laboratory Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera St. Lukes | Current | Accepting new patients | |
| Avera St. Luke'S | Current | Accepting new patients | |
| Integrated Diagnostics | Current | Accepting new patients | |
| Avera St Lukes | Current | Accepting new patients | |
| Pathology Associates of Sturdy Memorial Hospital Inc | Past | Accepting new patients | |
| Siouxland Pathology Group SMHC | Past | Accepting new patients |
Locations
201 E 4th St
Ste 203
South Sioux City, NE 68776
Phone (712) 389-5242
305 S State St
Aberdeen, SD 57401
Phone (605) 229-3000
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Aberdeen, SD
- NPI 1215100813
-
- Anatomic Pathology & Clinical Pathology Physician
- South Sioux City, NE
- NPI 1437704251
-
- General Acute Care Hospital
- Aberdeen, SD
- NPI 1457309270
-
- Nephrology Physician
- Aberdeen, SD
- NPI 1477594430
-
- Anatomic Pathology & Clinical Pathology Physician
- Attleboro, MA
- NPI 1316013956
-
- Clinical Medical Laboratory
- Sioux City, IA
- NPI 1629051842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1962486530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008",
"telephone_number": "904-244-4387",
"fax_number": "904-244-4060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 FULLER RD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481052303",
"telephone_number": "734-845-3427",
"fax_number": "734-845-3207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISAR",
"first_name": "NAUMAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "KY",
"license": "54745",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "14S1J",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003138169A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009607400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.