Missra Rezvani, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

19140 Issued in CA

Practice address

1010 W la Veta Ave
Ste 750
Orange, CA 92868-4300

Phone

(714) 361-6600

NPI assigned

Jul 22, 2010

Sex

Female

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 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Newport Care Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Newport Beach, CA
  • NPI 1528401783
  Medicare reassignment NPD
• Newport Care Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Los Alamitos, CA
  • NPI 1922852490
  NPD

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1043523707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR",
            "address_2": "STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683854",
            "telephone_number": "714-639-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE",
            "address_2": "STE 750",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684300",
            "telephone_number": "714-361-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZVANI",
        "first_name": "MISSRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "19140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE (NP)",
            "identifier": "19140",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE (RN)",
            "identifier": "670627",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reza Shahbaz MD Inc
• Karen Reza
• Mona Rezaei Mirghaed, M.D.
• Arash Rezazadeh Kalebasty, M.D.
• Sherif Rezk, M.D.
• Charles Chuljoo Rhee, M.S. T, M. ED, DBH
• Laura Rhee
• Rheomed Mso, Inc
• Ruth Rhoades
• Bradford Rhoads

• Adult Health Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.