Tahira F Mirza, M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

257617 Issued in MA

Practice address

55 Fogg Rd
Weymouth, MA 02190-2432

Phone

(781) 792-4121

Fax

(781) 878-6750

NPI assigned

Feb 6, 2008

Last updated

Aug 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1063690691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "address_2": "COASTAL MEDICAL ASSOCIATES",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000",
            "fax_number": "781-878-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-792-4121",
            "fax_number": "781-878-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "TAHIRA",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-119777",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CT",
            "license": "042481",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301072064",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "257617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119777",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Smith Miller, MS
• Michelle Millerd, CNM
• Rhonda Milner
• Christina Jo Minich, LCSW, LICSW
• Richard D Mirel, M.D.
• Daniel S. Mishkin, M.D.
• Suzanne Missert
• Amanda Moffitt, LMHC
• Shahram Moghaddam, D.M.D.
• Emily M Mohr, PHD

• Surgical Critical Care Physician in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Surgical Critical Care Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.