Reza Mobarak, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1714 Issued in TX

Practice address

502 N Valley Pkwy
Ste 2
Lewisville, TX 75067-3437

Phone

(972) 316-0902

Fax

(972) 316-1161

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Cla Physicians Group IncGroup PAC ID 6709131352, 2 clinicians

Southwest Surgery and Wound Care PhysiciansGroup PAC ID 2668539198, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lucent Home Health LLC Home health agency, Plano, TX, CCN 743191

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Southwest Surgery and Wound Care Physicians

  • Foot & Ankle Surgery Podiatrist
  • Plano, TX
  • NPI 1841436078
  Medicare reassignment Care Compare group NPD Authorized official
• Cla Physicians Group Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Dallas, TX
  • NPI 1285145532
  Medicare reassignment Care Compare group NPD
• Anadel Professionals LLC

  • Foot & Ankle Surgery Podiatrist
  • Frisco, TX
  • NPI 1982179974
  NPD
• Dharmesh Bhakta, DPM, PA

  • Foot & Ankle Surgery Podiatrist
  • Arlington, TX
  • NPI 1114051463
  NPD (past)
• Karen Elizabeth Chagnon Dba Senior Care Associates of Texas

  • Podiatrist
  • Arlington, TX
  • NPI 1871700013
  NPD (past)

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

• Lucent Home Health LLC

  • Home Health Agency
  • Plano, TX
  • NPI 1649462334
  Care Compare affiliation

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1013962539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 N VALLEY PKWY",
            "address_2": "STE 2",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673437",
            "telephone_number": "972-316-0902",
            "fax_number": "972-316-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N VALLEY PKWY",
            "address_2": "STE 2",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673437",
            "telephone_number": "972-316-0902",
            "fax_number": "972-316-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBARAK",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190455902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Walker Mirsky, MS, CCC-SLP
• Freeda M Mitchell, LMFT
• Jennifer Eleen Mitchell, PA-C
• Robyn Mitchell
• Amber Mkinga
• Mobility Health Inc.
• Nishani Modi, MS, CCC-SLP
• Dedra Dianne Moffat, LPC-A
• Momfully You, PLLC
• Naileen Abdul Momin, AU D

• Foot & Ankle Surgery Podiatrist in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.