Individual provider Active NPI

Mehrab Jonathon Zarian-Dero, P.A

  • Medical Physician Assistant
  • Norcross, GA
National Provider Identifier
1700903135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002434 Issued in GA
Practice address
5775 Jimmy Carter Blvd
#200
Norcross, GA 30071-2989
Phone
(678) 646-3627
NPI assigned
Mar 22, 2007
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
Medical Physician Assistant 363AM0700X 002434 GA Primary

Addresses

Primary practice location

5775 Jimmy Carter Blvd
#200
Norcross, GA 30071-2989

Mailing address

459 Rock Springs Rd NE
Atlanta, GA 30324-5101
Phone (404) 875-6288

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002434GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Cardiovascular Surgeons at Saint Joseph'S LLC Past Accepting new patients
Peachatree Cardiovascular & Thoracic Surgeons, P.a. PastSince Jul 23, 1992 Accepting new patients
Surgical Assistants of America, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700903135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 ROCK SPRINGS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245101",
            "telephone_number": "404-875-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 JIMMY CARTER BLVD",
            "address_2": "#200",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300712989",
            "telephone_number": "678-646-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARIAN-DERO",
        "first_name": "MEHRAB",
        "middle_name": "JONATHON",
        "name_prefix": "Mr.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.