Active NPI
Reza Eshraghi
- Anatomic Pathology Physician
- Tampa, FL
National Provider Identifier
1104246263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- ME150175
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-4673
- NPI assigned
- Apr 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | ME150175 | FL | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 1104246263 | IL |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 198441
Atlanta, GA 30384-8441
Phone (708) 216-3250
Other practice location 1
2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-3250
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | reza.eshraghi@direct.moffitt.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778
Hospital & facility affiliations
- H Lee Moffitt Cancer Center & Research Institute I
- Adventhealth Tampa
- St Josephs Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88 of 100
- Quality
- 74.04
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME150175 | FL | MD | Anatomic Pathology Physician |
| 1104246263 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc | Current | Accepting new patients |
Locations
12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720
Interoperability endpoints
- reza.eshraghi@direct.moffitt.org
Organizations & group practices 1
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.
-
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1104246263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198441",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848441",
"telephone_number": "708-216-3250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-4673"
}
],
"practiceLocations": [
{
"address_1": "2160 S 1st Ave",
"address_purpose": "LOCATION",
"city": "Maywood",
"state": "IL",
"postal_code": "601533328",
"country_code": "US",
"telephone_number": "708-216-3250",
"fax_number": "708-327-2620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESHRAGHI",
"first_name": "REZA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-16",
"last_updated": "2021-09-07",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "FL",
"license": "ME150175",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "1104246263",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "reza.eshraghi@direct.moffitt.org",
"affiliation": "N",
"address_1": "12902 Usf Magnolia Dr",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336129416",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.