Individual provider Active NPI

Mozibur Rahman

  • Anatomic Pathology & Clinical Pathology Physician
  • Lafayette, LA
National Provider Identifier
1124673223
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
346366 Issued in LA
Practice address
1214 Coolidge Blvd FL 3
Lafayette, LA 70503-2621
Phone
(337) 289-7679
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 346366 LA Primary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X 318988-01 NY

Addresses

Primary practice location

1214 Coolidge Blvd FL 3
Lafayette, LA 70503-2621

Mailing address

316 Redfern St
Lafayette, LA 70508-4487
Phone (914) 306-0170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250722000164 LA Practitioner - Pathology 6103332747 Reassigns benefits to 1 organization
I20251202002732 NY Practitioner - Pathology 6103332747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318988NYMDLicensed Practical Nurse
318988-01NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Anatomic Pathology Services, Inc. Multi-Specialty CurrentSince Jul 1, 2025 Accepting new patients
Westchester Medical Center Advanced Physician Services PC Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients
Preferred Anatomic Pathology Services, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2025 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

927 Harding St
Lafayette, LA 70503

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1101 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 231-5775

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

1214 Coolidge Blvd
Fl 3
Lafayette, LA 70503
Phone (337) 289-7679

1000 W Pinhook Rd
Ste 100
Lafayette, LA 70503
Phone (337) 289-8095

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1124673223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 REDFERN ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084487",
            "telephone_number": "914-306-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD FL 3",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "MOZIBUR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "346366",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "318988-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.