Individual provider Active NPI

Naureen Azamali Mirza-George, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1508922592
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A112459 Issued in CA
Practice address
5 Christian St
Philadelphia, PA 19147-4321
Phone
(215) 680-5571
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MT184366 PA
Ophthalmology Physician 207W00000X MD434804 PA
Ophthalmology Physician 207W00000X A112459 CA Primary

Addresses

Primary practice location

5 Christian St
Philadelphia, PA 19147-4321

Mailing address

395 Hickey Blvd
FL 5
Daly City, CA 94015-2770
Phone (215) 680-5571

Other names 1

  • Dr. Naureen Mirza Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101229000934 CA Practitioner - Ophthalmology 4183751696 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A112459CAMDOphthalmology Physician
MT184366PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Oct 1, 2010 Accepting new patients
Permanente Medical Group Inc Ophthalmology CurrentSince Oct 1, 2010 Accepting new patients
Permanente Medical Group Inc Ophthalmology Current Accepting new patients
UCSF Medical Group Business Services Ophthalmology Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

395 Hickey Blvd
Daly City, CA 94015
Phone (650) 301-5800

395 Hickey Blvd
Fl 5
Daly City, CA 94015
Phone (650) 301-5800

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1508922592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 HICKEY BLVD",
            "address_2": "FL 5",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152770",
            "telephone_number": "215-680-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CHRISTIAN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474321",
            "telephone_number": "215-680-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA-GEORGE",
        "first_name": "NAUREEN",
        "middle_name": "AZAMALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MT184366",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD434804",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A112459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "395 Hickey Blvd",
            "city": "Daly City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940152770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NAUREEN",
            "last_name": "MIRZA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.