Iraj Derakhshan, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

18591 Issued in WV

Practice address

1206 Quarrier St
Suite 101
Charleston, WV 25301-1810

Phone

(304) 343-4098

Fax

(304) 343-4598

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Pars Neurosurgical Associates, Inc

  • Neurological Surgery Physician
  • Parkersburg, WV
  • NPI 1457396152
  NPD (past)
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1124088380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 QUARRIER ST STE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011810",
            "telephone_number": "304-343-4098",
            "fax_number": "304-343-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 QUARRIER ST",
            "address_2": "SUITE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011810",
            "telephone_number": "304-343-4098",
            "fax_number": "304-343-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAKHSHAN",
        "first_name": "IRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "18591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000102711",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090508000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cameo Nichole Denton
• Robert Todd Depond, MD
• Michael Deprospero, M.D.
• Chasity Depta
• Leathia Depugh
• John A Derenburger
• Angela F. Derrick, APRN-CRNA
• Sandra Marie Derrick
• Savannah Grace Dervis, DDS
• Matthew Desanto, MD

• Specialist in Charleston, WV
• Providers in Charleston, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.