Kamran Goudarzi Surgical Practice PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

KAMRAN GOUDARZI SURGICAL PRACTICE PC

Practice address

710 Military Cutoff Rd Ste 130
Wilmington, NC 28405-2382

Phone

(910) 769-1079

Fax

(910) 769-6023

NPI assigned

Jul 27, 2018

Organization subpart

No

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

Authorized official

Name

Kamran Goudarzi, MDNPI 1972562593

Title

Owner

Phone

(910) 769-1079

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamran Goudarzi, M.D.

  • Surgery Physician
  • Wilmington, NC
  • NPI 1972562593
  Medicare reassignment Care Compare group NPD Authorized official
• Mandy Sangani, APRN

  • Nurse Practitioner
  • Wilmington, NC
  • NPI 1972259075
  Medicare reassignment Care Compare group NPD
• Yvonne Dao, PA-C

  • Physician Assistant
  • Wilmington, NC
  • NPI 1982281531
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1013494400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD STE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-769-1079",
            "fax_number": "910-769-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD STE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-769-1079",
            "fax_number": "910-769-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMRAN GOUDARZI SURGICAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-27",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "GOUDARZI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-769-1079",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Kalp, MD
• Brooke Kaminski
• Paul F Kamitsuka, MD
• Kamp, Wallace & Associates PLLC
• Amy Kampschroeder, OTR/L
• Kathleen M. Kane-Maxwell, P.T.
• Peter Kane, MD
• Jinson Kang, DMD
• Stuart Young Kaplan, DC
• Grace Kararo

• Surgery Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.