Individual provider Active NPI

Nasser Zolfaghari, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1386784262
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006559 Issued in NY
Practice address
MMC - Dept. of Medicine
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 920-2961
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4714 CT
Physician Assistant 363A00000X 006559 NY Primary

Addresses

Primary practice location

MMC - Dept. of Medicine
111 East 210TH Street
Bronx, NY 10467

Mailing address

505 E Lincoln Ave
Apt. 404
Mount Vernon, NY 10552-3557
Phone (718) 920-2961

Other practice location 1

24 Hospital Ave
Danbury, CT 06810-6077
Phone (203) 739-6752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080315000045 NY Practitioner - Physician Assistant 3072698075 Reassigns benefits to 1 organization
I20200311002104 CT Practitioner - Physician Assistant 3072698075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Howard University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000

29 Hospital PLZ
Stamford, CT 06902-3602

4 Hospital PLZ
Suite 102
Stamford, CT 06902-3602
Phone (203) 276-2330

5 High Ridge Park
Suite 103
Stamford, CT 06905-1326
Phone (203) 276-4644

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4714CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 28, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Apr 28, 2025 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: nzolfaghari24402@stamfordhealth.direct-ci.com

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1386784262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E LINCOLN AVE",
            "address_2": "APT. 404",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523557",
            "telephone_number": "718-920-2961",
            "fax_number": "718-920-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF MEDICINE",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-2961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106077",
            "country_code": "US",
            "telephone_number": "203-739-6752",
            "fax_number": "203-749-9087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOLFAGHARI",
        "first_name": "NASSER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4714",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.