Individual provider Active NPI

Naseem B. Razavi, MD

  • General Practice Physician
  • Hartford, CT
National Provider Identifier
1386913465
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
76796 Issued in CT
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

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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, FL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170412001635 TX Practitioner - Internal MedicinePractitioner - General Practice 5698051308 Reassigns benefits to 1 organization
I20240513003316 CT Practitioner - General Practice 5698051308
I20240531003533 FL Practitioner - General Practice 5698051308

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 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76796CTMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wind River Family & Community Healthc Care Multi-Specialty CurrentSince Aug 7, 2023 Accepting new patients
Naseem B. Razavi, MD LLC General Practice Current Accepting new patients
Naseem B. Razavi, MD LLC Multi-Specialty CurrentSince Mar 30, 2024 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.

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

Verify at the official NPI Registry.