Organization Active NPI

Monfared Primary Care LLC

  • Family Medicine Physician
  • Easton, PA
National Provider Identifier
1346865458
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONFARED PRIMARY CARE LLC
Practice address
124 N 14TH St
Easton, PA 18042-3218
Phone
(610) 438-0102
Fax
(610) 438-1254
NPI assigned
Jun 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

Name
Ziba Monfared, MDNPI 1467449074
Title
Owner
Phone
(610) 438-0102

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

124 N 14TH St
Easton, PA 18042-3218

Mailing address

124 N 14TH St
Easton, PA 18042-3218
Phone (610) 438-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200708001083 PA Part B Supplier - Clinic/Group Practice 1658794748 Receives reassigned benefits from 1 practitioner
Practice locations: Easton, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2188736Monfared Primary Care LLC124 North 14TH Street, Easton, PA 18042Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Colyn Nouv DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1346865458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N 14TH ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180423218",
            "telephone_number": "610-438-0102",
            "fax_number": "610-438-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N 14TH ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180423218",
            "telephone_number": "610-438-0102",
            "fax_number": "610-438-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONFARED PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "MONFARED",
        "authorized_official_first_name": "ZIBA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-438-0102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.