Individual provider Active NPI

Tala Ramzi Nasr, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1285817049
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
059481 Issued in GA
Practice address
300 W Clarendon Ave
Suite 375
Phoenix, AZ 85013-3420
Phone
(602) 277-4164
Fax
(602) 266-3481
NPI assigned
Dec 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 059481 GA Primary

Addresses

Primary practice location

300 W Clarendon Ave
Suite 375
Phoenix, AZ 85013-3420

Mailing address

300 W Clarendon Ave
Suite 375
Phoenix, AZ 85013-3420
Phone (602) 277-4164

Other identifiers 1

IdentifierTypeStateIssuer
0549481MedicaidGA

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
I20150225001888 TX Practitioner - Pediatric Medicine 1759552094 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059481GAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Jan 18, 2015 Accepting new patients
Baylor University Medical Center Past Accepting new patients
Baylor Medical Center at Irving Past Accepting new patients
Baylor Regional Medical Center at Grapevine Past Accepting new patients
Baylor Medical Center at Waxahachie Past Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Neonatal-Perinatal Medicine Past Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

1901 N MacArthur Blvd
Irving, TX 75061
Phone (972) 484-5192

3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855

6800 Scenic Dr
Rowlett, TX 75088
Phone (972) 412-2273

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1285817049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE 375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4164",
            "fax_number": "602-266-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE 375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4164",
            "fax_number": "602-266-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "TALA",
        "middle_name": "RAMZI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "059481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0549481",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.