Individual provider Active NPI

Iraj Golzari, MD

  • General Practice Physician
  • Venice, FL
National Provider Identifier
1689754426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0046011 Issued in FL
Practice address
1869 S Tamiami TR
Venice, FL 34293
Phone
(941) 497-0377
Fax
(941) 497-0278
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME0046011 FL Primary

Addresses

Primary practice location

1869 S Tamiami TR
Venice, FL 34293

Mailing address

1869 S Tamiami TR
Venice, FL 34293
Phone (941) 497-0377

Other identifiers 2

IdentifierTypeStateIssuer
CN4296OtherFLRR MEDICARE
2065681OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110331000421 FL Practitioner - Family Practice 6709069529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1869 S Tamiami Trail
Venice, FL 34293-3137
Phone (941) 497-0377

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
ME0046011FLMDGeneral Practice Physician

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: golzari@c5b13315.micromddirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689754426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 S TAMIAMI TR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-497-0377",
            "fax_number": "941-497-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 S TAMIAMI TR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-497-0377",
            "fax_number": "941-497-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLZARI",
        "first_name": "IRAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0046011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN4296",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2065681",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.