Organization Active NPI

Pearl Institute PL

  • Specialist
  • Lutz, FL
National Provider Identifier
1386839660
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME89013 Issued in FL
Legal business name
PEARL INSTITUTE PL
Practice address
17551 N Dale Mabry Hwy
Lutz, FL 33548-4521
Phone
(813) 454-4044
Fax
(813) 265-3937
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Dr. Sadaf Bazargan, MDNPI 1265461941
Title
Owner
Phone
(813) 454-4044

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME89013 FL Primary

Addresses

Primary practice location

17551 N Dale Mabry Hwy
Lutz, FL 33548-4521

Mailing address

17551 N Dale Mabry Hwy
Lutz, FL 33548-4521
Phone (813) 454-4044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000347 FL Part B Supplier - Clinic/Group Practice 4688764822 Receives reassigned benefits from 1 practitioner
Practice locations: Lutz, FL

National Provider Directory

National Provider Directory

Locations

15421 N Florida Ave
Ste A
Tampa, FL 33613
Phone (813) 454-4044

Practitioners & affiliated clinicians

Practitioners 7

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": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1386839660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17551 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484521",
            "telephone_number": "813-454-4044",
            "fax_number": "813-265-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17551 N DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484521",
            "telephone_number": "813-454-4044",
            "fax_number": "813-265-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL INSTITUTE PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "BAZARGAN",
        "authorized_official_first_name": "SADAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-454-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME89013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.