Zia Ghavami, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA04003700 Issued in NJ

Practice address

119 Prospect St
Ridgewood, NJ 07450-4405

Phone

(201) 445-1212

NPI assigned

Jun 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Comprehensive Pediatric Care PC

  • Pediatrics Physician
  • Ridgewood, NJ
  • NPI 1336441336
  Authorized official Same address or phone

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1033154570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-445-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-445-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAVAMI",
        "first_name": "ZIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04003700",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "145846",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00589368",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3821200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genuine Rehabilitation Inc
• Nevin George
• William Robert Gerber, MSW, LCSW
• Susan Dale Gerstley, LCSW
• Yoo Jung Gessmann, M.A.
• Gabriella Leonora Giachin, LCSW
• Mary Elizabeth Giacona, DDS
• Cynthia Ann Gilbert-Pattison, DMD
• William Gilligan, P.T.
• Howard Eliot Gilman, M.D.

• Pediatrics Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.