Firdausi F Mazda, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036-053459 Issued in IL

Practice address

360 W Butterfield Rd
Ste 245
Elmhurst, IL 60126-5068

Phone

(630) 941-2646

Fax

(630) 941-3464

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

Yes

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 IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Firdausi F. Mazda, M.D.,S.C.

  • Urology Physician
  • Elmhurst, IL
  • NPI 1285769968
  Authorized official Same address or phone
• United Shockwave Services, LTD.

  • Ambulatory Surgical Clinic/Center
  • La Grange, IL
  • NPI 1336526219
  NPD
• United Shockwave Services, LTD.

  • Lithotripsy Clinic/Center
  • Park Ridge, IL
  • NPI 1811944515

  Urology

  NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1437138245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "STE 245",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-941-2646",
            "fax_number": "630-941-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "STE 245",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-941-2646",
            "fax_number": "630-941-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZDA",
        "first_name": "FIRDAUSI",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036-053459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360534593",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Thengumtharayil Mathew, DO
• Riny Thomas Mathew, APN/CNP
• Melinda Sue Mathews, MA, LCPC
• Sarah Anne Mathiason, APN
• David M Matusiak, DO
• Stephany Lynne Mazur, M.D.
• Nakia J McAdoo, APN-CRNA
• Christina Louise McBride
• Nicholas James McCabe, M.S.CCC-SLP/L
• Michele M McClory, APN-CNP

• Urology Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.