Flora Fazeli, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD27444 Issued in OR

Practice address

1750 Blankenship Rd
West Linn, OR 97068-5101

Phone

(503) 210-4900

Fax

(503) 210-4998

NPI assigned

Jan 22, 2007

Last updated

Oct 1, 2012By the provider in NPPES

Sex

Female

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 OR

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 Medicine

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1215081112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 BLANKENSHIP RD",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970685101",
            "telephone_number": "503-210-4900",
            "fax_number": "503-210-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 BLANKENSHIP RD",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970685101",
            "telephone_number": "503-210-4900",
            "fax_number": "503-210-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZELI",
        "first_name": "FLORA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "LL16545",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD27444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Foot Clinic LLC
• Susan Ann Farah, LMT
• David B Farley, M.D.
• James A Farley, MD
• Farnaz Dana Fakhari, MD, PC (Dermatology & Skin Care Center of West Linn)
• Larry Fein Jr., RN
• Rebecca Anne Feuerherd
• Megan Flanagan, MA, LPC, LMHC
• Forbes Optical PC
• Nicole Leigh Forbes, PMHNP-BC

• Internal Medicine Physician in West Linn, OR
• Providers in West Linn, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.