Katayoon Baradaran Ebrahimi, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

18004 Issued in ND

Practice address

1717 University Dr S
Fargo, ND 58103-4939

Phone

(701) 461-5100

NPI assigned

Jan 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Katayoon Baradaran Ebrahimi Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1104282359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "701-234-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034939",
            "telephone_number": "701-461-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-9010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 FILBERT ST",
            "address_purpose": "LOCATION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "country_code": "US",
            "telephone_number": "215-662-8100",
            "fax_number": "215-662-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARADARAN EBRAHIMI",
        "first_name": "KATAYOON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2016-01788",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD463064",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ND",
            "license": "18004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kebrahimi17261330@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "3801 FILBERT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191042640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATAYOON",
            "last_name": "BARADARAN EBRAHIMI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Balvitsch, PA-C
• Rosetta F Bana
• Ranell Bang
• Katie Banley, CNP
• Ladonna Bannach, OTR/L
• Cami Barber, DPT
• Brenda M Barfield, DDS
• Scott Barglof
• Elisabeth Anne Barlow, CNP
• Mykell M Barnacle, NP

• All providers in Fargo, ND
• Ophthalmology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.