Behrouz Madani, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME26731 Issued in FL

Practice address

13540 17TH St
Dade City, FL 33525-5244

Phone

(352) 567-1411

Fax

(352) 567-6391

NPI assigned

May 24, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  NPD (past)
• Pasco Hernando Hma Physician Management, LLC

  • Obstetrics & Gynecology Physician
  • Dade City, FL
  • NPI 1003848359
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1477556272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335261177",
            "telephone_number": "352-521-1569",
            "fax_number": "352-521-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13540 17TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255244",
            "telephone_number": "352-567-1411",
            "fax_number": "352-567-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADANI",
        "first_name": "BEHROUZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME26731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279121800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51076",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Logan, PH.D.
• Kristina May Lombardi, R.PH, PHARM.D., BCPS
• Nichole Marie Long
• Luminescence Therapy LLC
• David Michael Lustig, M.D.
• Michael L Maggard, O.D.
• Emad Mansour
• James Edward Martinez, RPH
• Nancy T Mathew
• Stephanie Mathis, MSN, FNP-BC

• All providers in Dade City, FL
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.