Individual provider Active NPI

Mazen Farouk Hariri, D.O.

  • Family Medicine Physician
  • Mesquite, TX
National Provider Identifier
1740628213
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S8569 Issued in TX
Practice address
820 E Cartwright Rd Ste 100
Mesquite, TX 75149-6063
Phone
(214) 320-7600
NPI assigned
Jun 6, 2013
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15044 CA
Family Medicine Physician 207Q00000X S8569 TX Primary

Addresses

Primary practice location

820 E Cartwright Rd Ste 100
Mesquite, TX 75149-6063

Mailing address

820 E Cartwright Rd Ste 100
Mesquite, TX 75149-6063
Phone (214) 320-7600

Other practice location 1

3 Harbor Dr Ste 111
Sausalito, CA 94965-1491
Phone (415) 683-2988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170124001745 CA Practitioner - Osteopathic Manipulative Medicine 1850526831 Reassigns benefits to 1 organization
I20210201000404 TX Practitioner - Family Practice 1850526831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Medical Physician GroupGroup PAC ID 7517194491, 17 clinicians

Practice addresses (Care Compare)

820 E Cartwright Rd
Suite 100
Mesquite, TX 75149-6063
Phone (214) 320-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
15044CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Medical Physician Group Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Prima Medical Foundation CurrentSince Feb 1, 2017 Accepting new patients
Dallas Medical Physician Group CurrentSince Jan 1, 2021 Accepting new patients

Locations

1260 S Eliseo Dr
Fl 2
Greenbrae, CA 94904
Phone (415) 464-1350

3 Harbor Dr
Ste 111
Sausalito, CA 94965
Phone (415) 683-2988

5308 N Galloway Ave
Mesquite, TX 75150
Phone (972) 226-0505

820 E Cartwright Rd
Ste 100
Mesquite, TX 75149
Phone (214) 320-7600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1740628213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E CARTWRIGHT RD STE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496063",
            "telephone_number": "214-320-7600",
            "fax_number": "833-535-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E CARTWRIGHT RD STE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751496063",
            "telephone_number": "214-320-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Harbor Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Sausalito",
            "state": "CA",
            "postal_code": "949651491",
            "country_code": "US",
            "telephone_number": "415-683-2988",
            "fax_number": "415-683-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARIRI",
        "first_name": "MAZEN",
        "middle_name": "FAROUK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "15044",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.