Active NPI
Seyed Razi Dadgar
- Surgical Technologist
- Rockville, MD
National Provider Identifier
1144630476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 12-110
- Practice address
- 2403 Research Blvd
Ste 200
Rockville, MD 20850-6233 - Phone
- (301) 337-6412
- Fax
- (240) 912-4471
- NPI assigned
- May 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 12-110 | MD | Primary |
Addresses
Primary practice location
2403 Research Blvd
Ste 200
Rockville, MD 20850-6233
Mailing address
2403 Research Blvd
Ste 200
Rockville, MD 20850-6233
Phone (301) 337-6412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12-110 | Other | MD | SURGICAL ASSISTANT |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12-110 | MD | MD | Surgical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shady Grove Minimally Invasive | Past | Accepting new patients | |
| Shady Grove Surgery Center LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1144630476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 RESEARCH BLVD",
"address_2": "STE 200",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208506233",
"telephone_number": "301-337-6412",
"fax_number": "240-912-4471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2403 RESEARCH BLVD",
"address_2": "STE 200",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208506233",
"telephone_number": "301-337-6412",
"fax_number": "240-912-4471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DADGAR",
"first_name": "SEYED RAZI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-08",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "MD",
"license": "12-110",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SURGICAL ASSISTANT",
"identifier": "12-110",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.