Hajira Iftikheu Mirza, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Poly Clinical 2501 N. 3Rd Street
2ND Floor
Harrisburg, PA 17110

Phone

(330) 363-6223

Fax

(330) 453-4263

NPI assigned

Jun 29, 2022

Last updated

Oct 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004
• Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment Care Compare group NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• Penn State Health Medical Group, LLC

  • Surgery Physician
  • Camp Hill, PA
  • NPI 1922771534
  NPD
• Penn State Health Medical Group, LLC

  • Dermatology Physician
  • Camp Hill, PA
  • NPI 1407500143
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Penn State Health Hampden Medical Center

  • General Acute Care Hospital
  • Enola, PA
  • NPI 1164029658
  Care Compare affiliation
• Penn State Health Holy Spirit Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Camp Hill, PA
  • NPI 1659566008

  Hospital

  Care Compare affiliation
• Penn State Health Holy Spirit Medical Center

  • General Acute Care Hospital
  • Camp Hill, PA
  • NPI 1881690212
  Care Compare affiliation

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1982336871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE, FORBES TOWER",
            "address_2": "PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "330-363-6223",
            "fax_number": "330-453-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "POLY CLINICAL 2501 N. 3RD STREET",
            "address_2": "2ND FLOOR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "330-363-6223",
            "fax_number": "330-453-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "HAJIRA",
        "middle_name": "IFTIKHEU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-10-19",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Joann Minnich, RD
• Cayleigh M Minter, CRNP
• Miracle Group Inc
• Jaclyn Mirault, MD
• Mirror Home Care LLC
• Jose Enrique Misas, M.D.
• Irina Vladimirovna Mishagina, M.D.
• Gautam Mishra, MD
• Kevin Misner, MD
• Clare Missimer

• Student in an Organized Health Care Education/Training Program in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.