NPIMap

Individual provider Active NPI

David Farzan, MD

  • Family Medicine Physician
  • Lawrence, MA
National Provider Identifier
1093719924
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74355 Issued in MA
Practice address
25 Marston St
3Rd FL
Lawrence, MA 01841-2310
Phone
(978) 688-3100
Fax
(978) 557-8633
NPI assigned
Jun 9, 2005
Last updated
Feb 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74355 MA Primary

Addresses

Primary practice location

25 Marston St
3Rd FL
Lawrence, MA 01841-2310

Mailing address

25 Marston St
3Rd FL
Lawrence, MA 01841-2310
Phone (978) 688-3100

Other identifiers 12

IdentifierTypeStateIssuer
0016298OtherNEIGHBORHOOD HEALTH PLAN
975494OtherNETWORK HEALTH
4221511OtherCIGNA HEALTHCARE
91532OtherHEALTHSOURCE
01-00557OtherEVERCARE
080165006OtherRAILROAD MEDICARE
074355OtherMATUFTS HEALTH PLAN
3086054MedicaidMA
70293OtherMAHARVARD PILGRIM HEALTH CA
E91732OtherNHANTHEM BLUE CROSS
30008989OtherNHNH MEDICAID
J11639OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080613000553 MA Practitioner - Family Practice 1153376918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Medical and Walk in Center LLCGroup PAC ID 2769666999, 3 clinicians

Practice addresses (Care Compare)

25 Marston St
Lawrence, MA 01841-2310

25 Marston St
Suite 304
Lawrence, MA 01841-2358
Phone (978) 688-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimack Medical & Walk in S LLC Family Medicine CurrentSince Jan 1, 2017 Accepting new patients

Locations

25 Marston St
Ste 304
Lawrence, MA 01841
Phone (978) 688-3100

Interoperability endpoints

  • Direct secure messaging: david.farzan@mmwic.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IIFBBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IIFBBA/Endpoint/IIFBBA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1093719924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MARSTON ST",
            "address_2": "3RD FL",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412310",
            "telephone_number": "978-688-3100",
            "fax_number": "978-557-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MARSTON ST",
            "address_2": "3RD FL",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412310",
            "telephone_number": "978-688-3100",
            "fax_number": "978-557-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARZAN",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "74355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0016298",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "975494",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "4221511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "91532",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "01-00557",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080165006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "074355",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086054",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "70293",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "E91732",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH MEDICAID",
            "identifier": "30008989",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J11639",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.