Individual provider Active NPI

Murtadha Al-Kazzaz

  • Student in an Organized Health Care Education/Training Program
  • Thousand Oaks, CA
National Provider Identifier
1033978614
Registry record updated Sep 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone
(518) 709-9986
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

215 W Janss Rd
Thousand Oaks, CA 91360-1847

Mailing address

4 Merrall Dr
Clifton Park, NY 12065-7225
Phone (518) 709-9862

Other practice location 1

4 Merrall Dr
Clifton Park, NY 12065-7225
Phone (518) 709-9862

Other names 1

  • Dr. Murtadha Al-Kazzaz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757808000000",
    "number": "1033978614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MERRALL DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120657225",
            "telephone_number": "518-709-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601847",
            "telephone_number": "518-709-9986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Merrall Dr",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120657225",
            "country_code": "US",
            "telephone_number": "518-709-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-KAZZAZ",
        "first_name": "MURTADHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-09-14",
        "certification_date": "2025-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MURTADHA",
            "last_name": "AL-KAZZAZ",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2025; 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.