Active NPI
Sina Bahmanyar, MD
- Ophthalmology Physician
- Rockford, IL
National Provider Identifier
1174579577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Practice address
- 1075 Featherstone Rd
Ste 10
Rockford, IL 61107-5906 - Phone
- (815) 395-1157
- NPI assigned
- May 26, 2006
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | IL | Primary |
Addresses
Primary practice location
1075 Featherstone Rd
Ste 10
Rockford, IL 61107-5906
Mailing address
6785 Weaver Rd
Ste D
Rockford, IL 61114-8055
Phone (815) 395-1157
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036090289 | IL | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174579577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6785 WEAVER RD",
"address_2": "STE D",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148055",
"telephone_number": "815-395-1157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 FEATHERSTONE RD",
"address_2": "STE 10",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075906",
"telephone_number": "815-395-1157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAHMANYAR",
"first_name": "SINA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.