Organization Active NPI

Comprehensive Healthcare P a

  • Internal Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1326093527
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME72252 Issued in FL
Legal business name
COMPREHENSIVE HEALTHCARE P A
Practice address
575 N Clyde Morris Blvd Ste a
Daytona Beach, FL 32114-2318
Phone
(321) 355-7377
Fax
(800) 930-4957
NPI assigned
May 24, 2006
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Riaz Rahman, MDNPI 1275630717
Title
President
Phone
(321) 443-9924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME72252 FL Primary

Addresses

Primary practice location

575 N Clyde Morris Blvd Ste a
Daytona Beach, FL 32114-2318

Mailing address

646 Hills Blvd
Port Orange, FL 32127-2902
Phone (321) 443-9924

Other practice location 1

29122 Bellaire Boulevard
Suite 600
Richmond, TX 77407
Phone (713) 984-4546

Other identifiers 1

IdentifierTypeStateIssuer
252738300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, LA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040510001226 FL Part B Supplier - Clinic/Group Practice 6204825714 Receives reassigned benefits from 1 practitioner
Practice locations: Daytona Beach, FL
O20170120000357 TX Part B Supplier - Clinic/Group Practice 6204825714 Receives reassigned benefits from 1 practitioner
Practice locations: Stafford, TX
O20210114000142 LA Part B Supplier - Clinic/Group Practice 6204825714 Receives reassigned benefits from 1 practitioner
Practice locations: Harvey, LA

National Provider Directory

National Provider Directory

Locations

1200 W Granada Blvd
Ste A1
Ormond Beach, FL 32174
Phone (321) 355-7377

905 Beville Rd
Ste B
South Daytona, FL 32119
Phone (321) 355-7377

2439 Manhattan Blvd
Ste 102-1
Harvey, LA 70058
Phone (321) 443-9924

4103 S Main St
Stafford, TX 77477
Phone (321) 355-7377

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1326093527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 HILLS BLVD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272902",
            "telephone_number": "321-443-9924",
            "fax_number": "800-930-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N CLYDE MORRIS BLVD STE A",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142318",
            "telephone_number": "321-355-7377",
            "fax_number": "800-930-4957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29122 Bellaire Boulevard",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "77407",
            "country_code": "US",
            "telephone_number": "713-984-4546",
            "fax_number": "800-930-4957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPREHENSIVE HEALTHCARE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-01-18",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "RIAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-443-9924",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME72252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252738300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.