Hormoze A Goudarzi, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

26073 Issued in NC

Practice address

1721 New Hanover Medical Park Dr
Wilmington, NC 28403-5345

Phone

(910) 763-6571

Fax

(910) 763-6570

NPI assigned

Mar 17, 2006

Last updated

Dec 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: hgoudarzi1246402@direct.novanthealth.org

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.

• Atlantic Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1942334065
  Authorized official Same address or phone

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1598724783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-763-6571",
            "fax_number": "910-763-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035345",
            "telephone_number": "910-763-6571",
            "fax_number": "910-763-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDARZI",
        "first_name": "HORMOZE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "26073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "203334D",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goshen Medical Center Incorporated (Goshen Medical Center - Wilmington)
• Goshen Medical Center Incorporated (Pelican Family Medicine - Wrightsville Ave)
• Goshen Medical Center Incorporated (Pelican Family Medicine - Carolina Beach)
• Benjamin Robert Gosselin, DDS
• Bernard Gottschalk, MD
• Kamran Goudarzi, M.D.
• Cailyn Grace Gould
• Martin Scott Gould, DDS, MS
• Ashley Elizabeth Gousios, MS, RDN, LDN, CNSC
• Alyssa Gowdy, PA-C

• Surgery Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.