Individual provider Active NPI

Zia Ahmad Dehqanzada, M.D.

  • Surgery Physician
National Provider Identifier
1003015652
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101233249 Issued in VA
Practice address
CMR 442
Box 291
Apo, AE 09042
Phone
496221173440
Fax
496221173427
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101233249 VA Primary

Addresses

Primary practice location

CMR 442
Box 291
Apo, AE 09042

Mailing address

359 Redwing Dr
Woodland, CA 95695-5868
Phone (916) 817-7268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130810000092 CA Practitioner - General Surgery 6103099023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trauma Medical Group of Roseville IncGroup PAC ID 4880609767, 11 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-1382

2 Medical Plaza Dr
Suite 275
Roseville, CA 95661-3051
Phone (916) 797-7534

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101233249VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zia a Dehqanzada MD Apc CurrentSince May 29, 2013 Accepting new patients
Trauma Medical Group of Roseville Inc CurrentSince Jul 10, 2013 Accepting new patients
El Paso County Hospital District Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2 Medical Plaza Dr
Ste 275
Roseville, CA 95661
Phone (916) 462-8410

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

Interoperability endpoints

  • Direct secure messaging: zdehqanzada172282@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1003015652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 REDWING DR",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955868",
            "telephone_number": "916-817-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "CMR 442",
            "address_2": "BOX 291",
            "city": "APO",
            "state": "AE",
            "postal_code": "09042",
            "telephone_number": "496221173440",
            "fax_number": "496221173427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHQANZADA",
        "first_name": "ZIA",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101233249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.