Individual provider Active NPI

Roya Khodaparast, DC

  • Chiropractor
  • Mesquite, TX
National Provider Identifier
1124359039
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11351 Issued in TX
Practice address
2007 N Galloway Ave
Mesquite, TX 75149-1552
Phone
(972) 285-0010
Fax
(972) 285-0295
NPI assigned
Jan 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11351 TX Primary

Addresses

Primary practice location

2007 N Galloway Ave
Mesquite, TX 75149-1552

Mailing address

2007 N Galloway Ave
Mesquite, TX 75149-1552
Phone (972) 285-0010

Other identifiers 1

IdentifierTypeStateIssuer
11351OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525001066 TX Practitioner - Chiropractic 1850420183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2007 N Galloway Ave
Mesquite, TX 75149-1552
Phone (972) 285-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11351TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roya Khodaparast DC PC Chiropractor CurrentSince Feb 11, 2010 Accepting new patients

Locations

2007 N Galloway Ave
Mesquite, TX 75149
Phone (972) 285-0010

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": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1124359039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491552",
            "telephone_number": "972-285-0010",
            "fax_number": "972-285-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751491552",
            "telephone_number": "972-285-0010",
            "fax_number": "972-285-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAPARAST",
        "first_name": "ROYA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.