Individual provider Active NPI

Nazanin Moossavi, M.D

  • Family Medicine Physician
  • Wichita Falls, TX
National Provider Identifier
1255627774
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP10040027 Issued in TX
Practice address
1301 3Rd St
Ste#200
Wichita Falls, TX 76301-2245
Phone
(214) 709-3440
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10040027 TX Primary

Addresses

Primary practice location

1301 3Rd St
Ste#200
Wichita Falls, TX 76301-2245

Mailing address

11519 Harbor Rd
Frisco, TX 75035-5868
Phone (214) 709-3440

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
I20141022002603 TX Practitioner - Family Practice 0547481285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avesta Medical Services, PLLCGroup PAC ID 9436309788, 2 clinicians

Practice addresses (Care Compare)

1208 Village Creek Dr
Suite 104
Plano, TX 75093-4452
Phone (214) 974-4710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10040027TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avesta Medical Services, PLLC Family Medicine CurrentSince Jan 20, 2022 Accepting new patients

Locations

1208 Village Creek Dr
Ste 104
Plano, TX 75093
Phone (214) 974-4710

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIAGCD/Endpoint/GIAGCD
  • Direct secure messaging: nazanin.moossavi@amsp.eclinicaldirectplus.com

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 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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1255627774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11519 HARBOR RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750355868",
            "telephone_number": "214-709-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 3RD ST",
            "address_2": "STE#200",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763012245",
            "telephone_number": "214-709-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSSAVI",
        "first_name": "NAZANIN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10040027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.