Individual provider Active NPI

Reza Jarrahizadeh

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1477977130
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04831 Issued in NC
Practice address
13523 Plaza Road Ext
Charlotte, NC 28215-8921
Phone
(704) 316-4990
NPI assigned
Feb 14, 2014
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04831 NC Primary

Addresses

Primary practice location

13523 Plaza Road Ext
Charlotte, NC 28215-8921

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20140528002354 NC Practitioner - Physician Assistant 2567685100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4221 Tuckaseegee Rd
Charlotte, NC 28208-2801
Phone (704) 395-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-04831NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of North Carolina, P.C. CurrentSince Apr 17, 2017 Accepting new patients

Locations

4221 Tuckaseegee Rd
Charlotte, NC 28208
Phone (704) 392-4057

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1477977130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13523 PLAZA ROAD EXT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158921",
            "telephone_number": "704-316-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRAHIZADEH",
        "first_name": "REZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-14",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.