Roozbeh Yazdani, OPTOMETRIST

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA 1706 Issued in GA

Practice address

250 Furniture Dr
Cornelia, GA 30531

Phone

(706) 778-2152

Fax

(706) 894-1227

NPI assigned

Oct 4, 2006

Last updated

Jan 30, 2020By 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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr. Roozbeh Yazdani OD PC

  • Optometrist
  • Cornelia, GA
  • NPI 1821248980
  Authorized official Same address or phone

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1639265267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 FURNITURE DRIVE",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305315388",
            "telephone_number": "706-778-2152",
            "fax_number": "706-894-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 FURNITURE DR",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "30531",
            "telephone_number": "706-778-2152",
            "fax_number": "706-894-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZDANI",
        "first_name": "ROOZBEH",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA 1706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP.
• Walgreen Co (Walgreens #19973)
• Shaneka Ware
• Franklin Wolf, LMT
• Hannah Yancey

• Optometrist in Cornelia, GA
• Providers in Cornelia, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.