MARIAM K. ISHAQ PA-C - NPI 1639985245 - Physician Assistant in Canton, GA

Q: What is Mariam Ishaq's NPI number?

The NPI number for Mariam Ishaq is 1639985245. It was assigned to this individual provider in the NPPES registry on December 9, 2024.

Q: What is Mariam Ishaq's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mariam Ishaq was last updated on March 2, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Mariam K. Ishaq Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIAM K. ISHAQ PA-C (NPI 1639985245) is an individual physician assistant in Canton, Georgia, licensed in Georgia (12436) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Cherokee, and is a graduate of Mercer University School Of Medicine (2024).

NPPES Registry Identity

NPI1639985245

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMARIAM K. ISHAQCredential: PA-C

Location Address470 NORTHSIDE CHEROKEE BLVD STE 480Canton, GA 30115-8034

Mailing Address470 Northside Cherokee Blvd Ste 480Canton, GA 30115-8034 · (404) 845-8200

Phone(404) 845-8200

Sole ProprietorNo

Medical School CMSMercer University School Of MedicineGraduated 2024

Enumeration DateDecember 9, 2024

Last NPPES UpdateMarch 2, 20252 updates tracked since enumeration

NPPES CertifiedMarch 2, 2025

✔ NPI 1639985245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 12436

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

470 NORTHSIDE CHEROKEE BLVD STE 480, Canton, GA 30115

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mariam K. Ishaq Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688102825

PECOS Enrollment IDI20250115002251

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110008

Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MORGAN ALTAMIRANO AGACNP-C

Nurse Practitioner