Mohammad Tamim Mukhtarzada, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003539 Issued in PA

Practice address

3060 Center Valley Pkwy Ste 822
Center Valley, PA 18034-9040

Phone

(610) 791-0672

NPI assigned

Jun 25, 2019

Last updated

Oct 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Visionworks, Inc.

  dba Visionworks

  • Optometrist
  • Erie, PA
  • NPI 1063579837
  Medicare reassignment NPD
• Visionworks, Inc

  dba Visionworks

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD
• Luxottica of America Inc.

  dba LensCrafters #05105

  • Eyewear Supplier
  • Center Valley, PA
  • NPI 1255412003
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1164083697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 SUNRISE HWY",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414801",
            "telephone_number": "631-244-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 CENTER VALLEY PKWY STE 822",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180349040",
            "telephone_number": "610-791-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHTARZADA",
        "first_name": "MOHAMMAD",
        "middle_name": "TAMIM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "ORT009480",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret L Mitchell
• Patricia G Modestino, FNP
• Susan Dianne Mondaca, NCC, LPC
• Nichole Lynn Morrison, CRNP
• Catherine B Morrow, CRNP
• Katherine L Muller, PSYD
• Shawna Murphy, DO
• Myeyedr Optometry of Pennsylvania, LLC (MyEyeDr.)
• Courtney Ann Nace, NP
• Gaurav Nagar, MD

• Optometrist in Center Valley, PA
• Providers in Center Valley, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.