Active NPI
Naseem B. Razavi, MD
- General Practice Physician
- Hartford, CT
National Provider Identifier
1386913465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 76796
- Practice address
- 36 Russ St FL 3
Ste 738
Hartford, CT 06106-1520 - Phone
- (860) 310-9549
- NPI assigned
- Dec 20, 2011
- Reactivated
- Oct 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 76796 | CT | Primary |
Addresses
Primary practice location
36 Russ St FL 3
Ste 738
Hartford, CT 06106-1520
Mailing address
4107 Whisper Creek Drive
Morgantown, WV 26508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, CT, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
180 Fitzgerald Rd
Suite 2
Lakeland, FL 33813-2712
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76796 | CT | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wind River Family & Community Healthc Care | Multi-Specialty | Current | Accepting new patients |
| Naseem B. Razavi, MD LLC | General Practice | Current | Accepting new patients |
| Naseem B. Razavi, MD LLC | Multi-Specialty | Current | Accepting new patients |
Locations
36 Russ St
Fl 3
Hartford, CT 06106
Phone (301) 785-2099
14 Great Plains Rd
Arapahoe, WY 82510
Organizations & group practices 3
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.
-
- Federal Public Health Clinic/Center
- Arapahoe, WY
- NPI 1285006379
Multi-Specialty, TX
-
- General Practice Physician
- Concord, NH
- NPI 1811786254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1386913465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4107 WHISPER CREEK DRIVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 RUSS ST FL 3",
"address_2": "STE 738",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061061520",
"telephone_number": "860-310-9549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZAVI",
"first_name": "NASEEM",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-20",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"deactivation_date": "2013-10-24",
"reactivation_date": "2016-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "CT",
"license": "76796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.