Active NPI
Mahsa Ava Sohrab, M.D.
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Greenwich, CT
National Provider Identifier
1275845331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Plastic and Reconstructive Surgery Physician
- License
- 55552
- Practice address
- 25 Valley Dr Ste 2B
Greenwich, CT 06831-5203 - Phone
- (203) 340-1301
- Fax
- (442) 223-0286
- NPI assigned
- Jul 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 55552 | CT | |
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | 2844671 | NY | |
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | 55552 | CT | Primary |
Addresses
Primary practice location
25 Valley Dr Ste 2B
Greenwich, CT 06831-5203
Mailing address
25 Valley Dr Ste 2B
Greenwich, CT 06831-5203
Phone (203) 340-1301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A400150908 | Other | NY | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 5, 2023 through Dec 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2844671 | NY | MD | Ophthalmic Plastic and Reconstructive Surgery Physician |
Interoperability endpoints
- mahsa.sohrab.1@19314.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1275845331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 VALLEY DR STE 2B",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068315203",
"telephone_number": "203-340-1301",
"fax_number": "442-223-0286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 VALLEY DR STE 2B",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068315203",
"telephone_number": "203-340-1301",
"fax_number": "442-223-0286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOHRAB",
"first_name": "MAHSA",
"middle_name": "AVA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CT",
"license": "55552",
"primary": false
},
{
"code": "207WX0200X",
"taxonomy_group": "",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": "NY",
"license": "2844671",
"primary": false
},
{
"code": "207WX0200X",
"taxonomy_group": "",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": "CT",
"license": "55552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "A400150908",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.