Individual provider Active NPI

Azadeh Khayyat

  • Anatomic Pathology Physician
  • Orange, CA
National Provider Identifier
1063162675
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
A209711 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8888
NPI assigned
Mar 26, 2022
Last updated
Jul 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X A209711 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X WI

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8888

Other practice location 1

9200 W Wisconsin Ave Ste L83
Milwaukee, WI 53226-3522
Phone (414) 805-8576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Orange, CA 92863

PO Box
Suite 14091
Orange, CA 92863-1491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9421WIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1063162675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave Ste L83",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-8576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAYYAT",
        "first_name": "AZADEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-26",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A209711",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.