Individual provider Active NPI

Ehsaun Heydari, MD

  • Neurological Surgery Physician
  • Richmond, VA
National Provider Identifier
1497440234
Registry record updated Jun 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
1497440234 Issued in VA
Practice address
417 N 11TH St
Richmond, VA 23298-5024
Phone
(804) 828-9165
Fax
(804) 828-4493
NPI assigned
Apr 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 1497440234 VA Primary

Addresses

Primary practice location

417 N 11TH St
Richmond, VA 23298-5024

Mailing address

Vcuhs Gme Administration
Box 980257
Richmond, VA 23298-0257
Phone (804) 828-9783

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240320001330 VA Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 5395182828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1497440234VAMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1497440234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VCUHS GME ADMINISTRATION",
            "address_2": "BOX 980257",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980257",
            "telephone_number": "804-828-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N 11TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985024",
            "telephone_number": "804-828-9165",
            "fax_number": "804-828-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYDARI",
        "first_name": "EHSAUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "1497440234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.