Maryam Zehtabpour, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

11326 Issued in MN

Practice address

320 E Main St
Crosby, MN 56441-1645

Phone

(218) 546-7000

Fax

(218) 545-4456

NPI assigned

Jul 31, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ashraf Medical Group PLLCGroup PAC ID 1850560830, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ashraf Medical Group PLLC

  • Urgent Care Clinic/Center
  • Wappingers Falls, NY
  • NPI 1821387382
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1427480581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-7000",
            "fax_number": "218-545-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "564411645",
            "telephone_number": "218-546-7000",
            "fax_number": "218-545-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEHTABPOUR",
        "first_name": "MARYAM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "11326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSE",
            "identifier": "11326",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa Wigen, PA-C
• Amanda M Wilson, REGISTERED DIETITIAN
• Jamie Withrow, RD,LD,CDE
• Lindsey Anne Wolff, NP-C
• Ashley L Yager, APRN,CNP
• Mary M Zeise, O.D.

• Medical Physician Assistant in Crosby, MN
• Providers in Crosby, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.

Verify at the official NPI Registry.