Individual provider Active NPI

Iga Aizigov, FNP-C

  • Family Nurse Practitioner
  • Granger, IN
National Provider Identifier
1992155121
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28218728A Issued in IN
Practice address
50653 Hollybrook Dr
Granger, IN 46530-4947
Phone
(718) 208-0510
NPI assigned
Jun 19, 2016
Last updated
Oct 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28218728A IN Primary

Addresses

Primary practice location

50653 Hollybrook Dr
Granger, IN 46530-4947

Mailing address

50653 Hollybrook Dr
Granger, IN 46530-4947
Phone (718) 208-0510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1627 E Jefferson Blvd
Mishawaka, IN 46545-7103
Phone (718) 208-0510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Pointe LLC CurrentSince Dec 4, 2023 Accepting new patients
Lincoln Counseling, PC PastSince Mar 30, 2022 Accepting new patients

Locations

113 Lincolnway E
Mishawaka, IN 46544
Phone (574) 255-4976

1001 N Hickory Rd
Ste 3
South Bend, IN 46615
Phone (574) 232-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24035/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 1

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": "1466294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1992155121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50653 HOLLYBROOK DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304947",
            "telephone_number": "718-208-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50653 HOLLYBROOK DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304947",
            "telephone_number": "718-208-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIZIGOV",
        "first_name": "IGA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-19",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28218728A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.