Active NPI
Hassan S Mostafavipour, MD.
- Anatomic Pathology & Clinical Pathology Physician
- Tucker, GA
National Provider Identifier
1609059476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 048921
- Practice address
- 1777 Montreal Cir
Tucker, GA 30084-6802 - Phone
- (770) 621-7422
- Fax
- (770) 621-7530
- NPI assigned
- Dec 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 048921 | GA | Primary |
Addresses
Primary practice location
1777 Montreal Cir
Tucker, GA 30084-6802
Mailing address
1777 Montreal Cir
Tucker, GA 30084-6802
Phone (770) 621-7422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048921 | Other | GA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197590400000",
"number": "1609059476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 MONTREAL CIR",
"city": "TUCKER",
"state": "GA",
"postal_code": "300846802",
"telephone_number": "770-621-7422",
"fax_number": "770-621-7530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 MONTREAL CIR",
"city": "TUCKER",
"state": "GA",
"postal_code": "300846802",
"telephone_number": "770-621-7422",
"fax_number": "770-621-7530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSTAFAVIPOUR",
"first_name": "HASSAN",
"middle_name": "S",
"credential": "MD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-14",
"last_updated": "2007-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "GA",
"license": "048921",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "048921",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.