Individual provider Active NPI

Pervaiz Akhtar Chaudhry, MD

  • Vascular Surgery Physician
  • Fresno, CA
National Provider Identifier
1104804475
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A79662 Issued in CA
Practice address
30 E River Park PL W
#260
Fresno, CA 93720-1545
Phone
(559) 441-1774
Fax
(559) 441-0726
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A79662 CA Primary

Addresses

Primary practice location

30 E River Park PL W
#260
Fresno, CA 93720-1545

Mailing address

30 E River Park PL W
#260
Fresno, CA 93720-1545
Phone (559) 441-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Cardiac Surgery Medical Group CurrentSince Jan 1, 2010 Accepting new patients

Locations

1903 E Fir Ave
Ste 101
Fresno, CA 93720
Phone (559) 226-2722

1903 E Fir Ave
Ste 101Q
Fresno, CA 93720

30 E River Park Pl W
Ste 260
Fresno, CA 93720
Phone (559) 441-1774

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1104804475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E RIVER PARK PL W",
            "address_2": "#260",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201545",
            "telephone_number": "559-441-1777",
            "fax_number": "559-441-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E RIVER PARK PL W",
            "address_2": "#260",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201545",
            "telephone_number": "559-441-1774",
            "fax_number": "559-441-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHRY",
        "first_name": "PERVAIZ",
        "middle_name": "AKHTAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A79662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.