Dr. Maurice E. Zadeh, Optometrist, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA001234 Issued in GA

Legal business name

DR. MAURICE E. ZADEH, OPTOMETRIST, P.C.

Practice address

910 Holcomb Bridge Rd
Suite 100
Roswell, GA 30076-1981

Phone

(770) 992-6789

Fax

(770) 640-6789

NPI assigned

Aug 22, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Maurice E. Zadeh, O.D.NPI 1780677476

Title

Owner

Phone

(770) 992-6789

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Eyecare of Roswell Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Maurice Ebrahim Zadeh, O.D.

  • Optometrist
  • Roswell, GA
  • NPI 1780677476
  Medicare reassignment NPD Authorized official
• Michael L Serrano, OD

  • Optometrist
  • Stone Mountain, GA
  • NPI 1881687515
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1174515464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 HOLCOMB BRIDGE RD",
            "address_2": "STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761981",
            "telephone_number": "770-992-6789",
            "fax_number": "770-640-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761981",
            "telephone_number": "770-992-6789",
            "fax_number": "770-640-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MAURICE E. ZADEH, OPTOMETRIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "ZADEH",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-992-6789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA001234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000641319A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eyecare of Roswell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dr. Brian K. Howard P.C.
• Dr. Richard W. McCann Jr.
• Dr. Syed W. Rizvi
• Lisa Rene' Drake, M.D.
• Kailen Denisia Drayer, OTR
• Drdee Nutrition

• Optometrist in Roswell, GA
• Providers in Roswell, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.