Individual provider Active NPI

M Rahat Faderani, D.O., M.P.H.

  • General Practice Physician
  • Atlantis, FL
National Provider Identifier
1124271010
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS10474 Issued in FL
Practice address
5913 S Congress Ave
Atlantis, FL 33462-1303
Phone
(561) 965-4300
Fax
(561) 965-4399
NPI assigned
Oct 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS10474 FL Primary

Addresses

Primary practice location

5913 S Congress Ave
Atlantis, FL 33462-1303

Mailing address

5913 S Congress Ave
Atlantis, FL 33462-1303
Phone (561) 543-8888

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Rahat Faderani, DO, MPH, PA General Practice PastSince Oct 7, 2011 Accepting new patients

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1124271010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5913 S CONGRESS AVE",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621303",
            "telephone_number": "561-543-8888",
            "fax_number": "888-663-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5913 S CONGRESS AVE",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621303",
            "telephone_number": "561-965-4300",
            "fax_number": "561-965-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADERANI",
        "first_name": "M RAHAT",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-23",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS10474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.