NPIMap

Organization Active NPI

Morteza Mirhaidari D P M

  • Podiatrist
  • New Philadelphia, OH
National Provider Identifier
1053591271
Registry record updated Jan 20, 2012
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Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002348M Issued in OH
Legal business name
MORTEZA MIRHAIDARI D P M
Practice address
152 North Broadway
Suite 100
New Philadelphia, OH 44663
Phone
(330) 364-8884
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Authorized official

Name
Morteza Mirhaidari, D.P.M.
Title
Owner
Phone
(330) 364-8884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 36002348M OH Primary

Addresses

Primary practice location

152 North Broadway
Suite 100
New Philadelphia, OH 44663

Mailing address

152 North Broadway
Suite 100
New Philadelphia, OH 44663
Phone (330) 364-8884

Other identifiers 2

IdentifierTypeStateIssuer
CL5308OtherOHRAILROAD MEDICARE
0624793MedicaidOH

Other names 1

  • Dover Foot Clinic Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1053591271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 NORTH BROADWAY",
            "address_2": "SUITE 100",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "44663",
            "telephone_number": "330-364-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 NORTH BROADWAY",
            "address_2": "SUITE 100",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "44663",
            "telephone_number": "330-364-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTEZA MIRHAIDARI D P M",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "MIRHAIDARI",
        "authorized_official_first_name": "MORTEZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-364-8884",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002348M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL5308",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0624793",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dover Foot Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Philadelphia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.