Individual provider Active NPI

Amir Hossein Pezeshkmehr, M.D.

  • Pediatric Radiology Physician
  • Little Rock, AR
National Provider Identifier
1215101894
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
R8645 Issued in TX
Practice address
1 Childrens Way # 653
Little Rock, AR 72202
Phone
(501) 364-1000
Fax
(501) 364-4082
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R8645 TX
Diagnostic Radiology Physician 2085R0202X E-8292 AR
Vascular & Interventional Radiology Physician 2085R0204X E-8292 AR
Vascular & Interventional Radiology Physician 2085R0204X R8645 TX
Pediatric Radiology Physician 2085P0229X R8645 TX Primary

Addresses

Primary practice location

1 Childrens Way # 653
Little Rock, AR 72202

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1000

Other identifiers 1

IdentifierTypeStateIssuer
210182001MedicaidAR

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180828000600 TX Practitioner - Diagnostic Radiology 4385958446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6651 Main St
Houston, TX 77030-2351
Phone (832) 826-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8645TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group CurrentSince Mar 5, 2024 Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: apezeshkmehr286861@prddirect.texaschildrens.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1215101894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1000",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72202",
            "telephone_number": "501-364-1000",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKMEHR",
        "first_name": "AMIR",
        "middle_name": "HOSSEIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R8645",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-8292",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AR",
            "license": "E-8292",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "R8645",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "R8645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210182001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.