Individual provider Active NPI

Mahzad Saghebrai

  • Physical Therapy Assistant
  • Las Vegas, NV
National Provider Identifier
1356608608
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA8651 Issued in CA
Practice address
1120 N Town Center Dr Ste 120
Las Vegas, NV 89144-6302
Phone
(866) 960-7691
NPI assigned
Apr 11, 2012
Last updated
Mar 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0561 NV
Physical Therapy Assistant 225200000X PTA8651 CA Primary

Addresses

Primary practice location

1120 N Town Center Dr Ste 120
Las Vegas, NV 89144-6302

Mailing address

15007 Burbank Blvd Apt 205
Van Nuys, CA 91411-3649
Phone (310) 963-8858

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA8651CAMDPhysical Therapy Assistant
A-0561NVMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1356608608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15007 BURBANK BLVD APT 205",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914113649",
            "telephone_number": "310-963-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N TOWN CENTER DR STE 120",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446302",
            "telephone_number": "866-960-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGHEBRAI",
        "first_name": "MAHZAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-0561",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA8651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.