NPIMap

Individual provider Active NPI

Azizullah Mehrzad, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Owensboro, KY
National Provider Identifier
1518062819
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
57755 Issued in KY
Practice address
1000 Breckenridge St Ste 401
Owensboro, KY 42303-0878
Phone
(270) 688-4401
Fax
(270) 688-4409
NPI assigned
Sep 13, 2006
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 57755 KY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 01057692A IN

Addresses

Primary practice location

1000 Breckenridge St Ste 401
Owensboro, KY 42303-0878

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

4498 N 1st Ave
Evansville, IN 47710-3622
Phone (812) 436-7280

Other identifiers 1

IdentifierTypeStateIssuer
200446820MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amehrzad40930@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100630000687 IN Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5991836280 Reassigns benefits to 1 organization
I20230601002209 KY Practitioner - Internal Medicine 5991836280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1000 Breckenridge St
Suite 401
Owensboro, KY 42303-0878
Phone (270) 688-4401

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Deaconess Hospital, Inc Geriatric Medicine Current Accepting new patients
Deaconess Hospital Inc CurrentSince Aug 4, 2003 Accepting new patients
Owensboro Health Medical Group, Inc Geriatric Medicine CurrentSince May 1, 2023 Accepting new patients
Deaconess Hospital, Inc Geriatric Medicine CurrentSince Aug 4, 2003 Accepting new patients
Owensboro Health Medical Group, Inc Past Accepting new patients

Locations

1750 Oak Hill Rd
Evansville, IN 47711
Phone (812) 479-1777

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4498 N 1st Ave
Evansville, IN 47710
Phone (812) 436-7280

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1000 Breckenridge St
Ste 401
Owensboro, KY 42303
Phone (270) 685-1066

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: amehrzad1940@direct.deaconess.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1518062819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRECKENRIDGE ST STE 401",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423030878",
            "telephone_number": "270-688-4401",
            "fax_number": "270-688-4409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4498 N 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477103622",
            "country_code": "US",
            "telephone_number": "812-436-7280",
            "fax_number": "812-436-7290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHRZAD",
        "first_name": "AZIZULLAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "KY",
            "license": "57755",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IN",
            "license": "01057692A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200446820",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amehrzad40930@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1000 Breckenridge St Ste 401",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423030878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.