Organization Active NPI

Noushin a Firouzbakht MD PA

  • Obstetrics & Gynecology Physician
  • Fort Worth, TX
National Provider Identifier
1164843306
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NOUSHIN A FIROUZBAKHT MD PA
Practice address
1125 S Henderson St
Fort Worth, TX 76104-4464
Phone
(817) 878-2667
Fax
(817) 810-9541
NPI assigned
Dec 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Noushin Ashrafian Firouzbakht, MDNPI 1417154634
Title
Owner
Phone
(817) 878-2667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1125 S Henderson St
Fort Worth, TX 76104-4464

Mailing address

1125 S Henderson St
Fort Worth, TX 76104-4464
Phone (817) 878-2667

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 8178782667 Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141024000190 TX Part B Supplier - Clinic/Group Practice 6507087111 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2071142Noushin a Firouzbakht MD, PA1125 S Henderson St, Fort Worth, TX 76104Certificate of waiverJan 2, 2028

National Provider Directory

National Provider Directory

Locations

1325 Pennsylvania Ave
Ste 350
Ft Worth, TX 76104
Phone (817) 887-9389

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1164843306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044464",
            "telephone_number": "817-878-2667",
            "fax_number": "817-810-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044464",
            "telephone_number": "817-878-2667",
            "fax_number": "817-810-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOUSHIN A FIROUZBAKHT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "FIROUZBAKHT",
        "authorized_official_first_name": "NOUSHIN",
        "authorized_official_middle_name": "ASHRAFIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-878-2667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "8178782667",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1125 S Henderson St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.