Individual provider Active NPI

Jafar Kaydashti Zadeh, PA

  • Physician Assistant
  • Oceanside, CA
National Provider Identifier
1316060098
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 16473 Issued in CA
Practice address
3772 Mission Ave
Suite 122
Oceanside, CA 92058-1453
Phone
(760) 630-8400
NPI assigned
Apr 9, 2007
Last updated
Nov 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 16473 CA Primary

Addresses

Primary practice location

3772 Mission Ave
Suite 122
Oceanside, CA 92058-1453

Mailing address

1855 McCauley LN
Carlsbad, CA 92008-1171
Phone (858) 354-0233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 16473CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Health Medical Center Inc Past Accepting new patients
Geller Medical Corporation Physician Assistant Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1316060098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 MCCAULEY LN",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081171",
            "telephone_number": "858-354-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 MISSION AVE",
            "address_2": "SUITE 122",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581453",
            "telephone_number": "760-630-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADEH",
        "first_name": "JAFAR",
        "middle_name": "KAYDASHTI",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 16473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.