Individual provider Active NPI

Nasser Razack, M.D.

  • Diagnostic Radiology Physician
  • Detroit, MI
National Provider Identifier
1225141328
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301081063 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-5111
Fax
(313) 745-3500
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X ME92656 FL
Diagnostic Ultrasound Physician 2085U0001X ME92656 FL
Vascular & Interventional Radiology Physician 2085R0204X 2023020198 MO
Diagnostic Radiology Physician 2085R0202X ME92656 FL
Diagnostic Radiology Physician 2085R0202X 4301081063 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

PO Box 100374
Gainesville, FL 32610-0374
Phone (352) 265-0291

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-0301 ext. 50301

Other practice location 2

3801 S National Ave
Springfield, MO 65807-5210
Phone (000) 000-0000

Other identifiers 3

IdentifierTypeStateIssuer
105114500MedicaidFL
200125691MedicaidMO
4301081063OtherMIMI LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI, IL, NY, MO5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20050826000090 FL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 3375574668 Reassigns benefits to 12 organizations
I20160722002323 MI Practitioner - Interventional Radiology 3375574668 Reassigns benefits to 1 organization
I20180817002251 IL Practitioner - Diagnostic Radiology 3375574668 Reassigns benefits to 1 organization
I20230330002043 NY Practitioner - Diagnostic Radiology 3375574668 Reassigns benefits to 1 organization
I20230703000177 MO Practitioner - Interventional Radiology 3375574668 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proscan NCH Imaging LLCGroup PAC ID 6103233051, 104 clinicians
Nchmd IncGroup PAC ID 9436139565, 503 clinicians
Collier Hma Physician Management LLCGroup PAC ID 2769495167, 99 clinicians

Practice addresses (Care Compare)

1020 Crosspointe Dr
Suite 103
Naples, FL 34110-0918
Phone (239) 598-0035

335 31St St S
St Petersburg, FL 33712-1419
Phone (727) 289-7139

350 7TH St N
Naples Community Hospital
Naples, FL 34102-5754
Phone (239) 436-5100

6101 Pine Ridge Rd
Naples, FL 34119-3900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jul 15, 2018 Accepting new patients
Collier Hma Physician Management LLC CurrentSince Feb 1, 2019 Accepting new patients
Collier Hma Physician Management LLC CurrentSince Feb 1, 2019 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Simonmed Imaging Florida LLC Diagnostic Radiology CurrentSince Oct 21, 2023 Accepting new patients
Howard John Simon MD PC Diagnostic Radiology CurrentSince Oct 21, 2023 Accepting new patients
Carle West Physician Group Inc CurrentSince May 7, 2023 Accepting new patients
Port Charlotte Hma Physician Management LLC CurrentSince May 7, 2019 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 24, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Feb 1, 2019 Accepting new patients
Nchmd Inc Current Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
Proscan NCH Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 28, 2024 Accepting new patients
Nchmd, Inc CurrentSince Feb 1, 2019 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jan 13, 2023 Accepting new patients
Health Diagnostics of California a Professional Corporation Diagnostic Radiology CurrentSince Oct 21, 2023 Accepting new patients
Port Charlotte Hma Physician Management LLC CurrentSince May 7, 2019 Accepting new patients
Howard Simon MD PLLC Diagnostic Radiology CurrentSince Oct 21, 2023 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jan 13, 2023 Accepting new patients
Freeport Memorial Hospital CurrentSince Mar 8, 2023 Accepting new patients
VHS Physicians of Michigan CurrentSince Apr 23, 2025 Accepting new patients
Smi Imaging, LLC Diagnostic Radiology PastSince Oct 1, 2018 Accepting new patients
Bayfront Medical Center, Inc. Diagnostic Radiology Past Accepting new patients
Innovative Imaging Associates, PA Diagnostic Radiology PastSince Feb 1, 2007 Accepting new patients

Locations (25 of 56)

8370 Wilshire Blvd
Ste 110
Beverly Hills, CA 90211
Phone (323) 966-0000

155 N San Vicente Blvd
Beverly Hills, CA 90211
Phone (323) 433-7800

9134 W Olympic Blvd
Beverly Hills, CA 90212
Phone (310) 432-1000

6185 Paseo del Norte
Ste 110
Carlsbad, CA 92011
Phone (760) 494-0556

455 Hickey Blvd
Ste 200
Daly City, CA 94015
Phone (650) 757-2030

345 Saxony Rd
Ste 106
Encinitas, CA 92024
Phone (760) 436-4155

499 N El Camino Real
Ste C100
Encinitas, CA 92024
Phone (760) 334-4065

108 Green Valley Rd
#B
Freedom, CA 95019
Phone (831) 476-7711

15775 Laguna Canyon Rd
Ste 140
Irvine, CA 92618
Phone (949) 522-8120

24022 Calle de la Plata
Ste 100
Laguna Hills, CA 92653
Phone (949) 330-8996

14651 S Bascom Ave
Ste 120
Los Gatos, CA 95032
Phone (408) 356-0444

800 Pollard Rd
Ste B101
Los Gatos, CA 95032
Phone (406) 374-8897

665 Munras Ave
Ste 109
Monterey, CA 93940
Phone (831) 656-9800

105 South Dr
Ste 110
Mountain View, CA 94040
Phone (650) 259-3165

1690 Barton Rd
Ste 107
Redlands, CA 92373
Phone (909) 307-1941

345 Convention Way
Ste 1-D
Redwood City, CA 94063
Phone (650) 299-9906

10111 Hole Ave
Riverside, CA 92503
Phone (650) 299-9906

225 W Hospitality Ln
Ste 102
San Bernardino, CA 92408
Phone (909) 888-5000

8901 Activity Rd
Ste 103
San Diego, CA 92126
Phone (619) 354-4070

325 Sacramento St
San Francisco, CA 94111
Phone (408) 356-9013

1180 Post St
San Francisco, CA 94109
Phone (415) 248-3700

1005 Van Ness Ave
San Francisco, CA 94109
Phone (415) 229-7825

101 S San Mateo Dr
Ste 105
San Mateo, CA 94401
Phone (650) 343-1655

101 S San Mateo Dr
Ste 201
San Mateo, CA 94401
Phone (650) 343-1655

4144 Redwood Hwy
Ste B
San Rafael, CA 94903
Phone (415) 479-9907

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEJDBA/Endpoint/IEJDBA

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 3

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1225141328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100374",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100374",
            "telephone_number": "352-265-0291",
            "fax_number": "352-265-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-5111",
            "fax_number": "313-745-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-0301 x50301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075210",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZACK",
        "first_name": "NASSER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME92656",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "ME92656",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MO",
            "license": "2023020198",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME92656",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301081063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105114500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125691",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4301081063",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.