Individual provider Active NPI

Mohammad Mahdi Paryavi, MD

  • Emergency Medicine Physician
  • Wyomissing, PA
National Provider Identifier
1336529130
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036139794 Issued in IL
Practice address
100 N Park Rd
Apt 1445
Wyomissing, PA 19610-3044
Phone
(301) 802-0644
NPI assigned
Jun 5, 2015
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036139794 IL Primary

Addresses

Primary practice location

100 N Park Rd
Apt 1445
Wyomissing, PA 19610-3044

Mailing address

100 N Park Rd
Apt 1445
Wyomissing, PA 19610-3044
Phone (301) 802-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170802001200 PA Practitioner - Emergency Medicine 0648560342 Reassigns benefits to 3 organizations
I20190823003109 UT Practitioner - Emergency Medicine 0648560342 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Prospect Health Access Network, Inc. Emergency Medicine Current Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Emergency Medicine CurrentSince Aug 4, 2018 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients

Locations

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

750 W 800 N
Orem, UT 84057
Phone (801) 714-6000

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210

Organizations & group practices 8

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": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1336529130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N PARK RD",
            "address_2": "APT 1445",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103044",
            "telephone_number": "301-802-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N PARK RD",
            "address_2": "APT 1445",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103044",
            "telephone_number": "301-802-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARYAVI",
        "first_name": "MOHAMMAD",
        "middle_name": "MAHDI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036139794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.