Active NPI
Mazen Jaafar, M.D.
- Pediatrics Physician
- Prestonsburg, KY
National Provider Identifier
1750302782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 30466
- Practice address
- 5000 Ky Route 321 Ste 3124
Prestonsburg, KY 41653-9113 - Phone
- (606) 886-7635
- Fax
- (606) 886-7680
- NPI assigned
- Jul 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 30466 | KY | Primary |
Addresses
Primary practice location
5000 Ky Route 321 Ste 3124
Prestonsburg, KY 41653-9113
Mailing address
5000 Ky Route 321 Ste 3124
Prestonsburg, KY 41653-9113
Phone (606) 886-7635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64304660 | Medicaid | KY |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30466 | KY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1750302782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 KY ROUTE 321 STE 3124",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416539113",
"telephone_number": "606-886-7635",
"fax_number": "606-886-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 KY ROUTE 321 STE 3124",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416539113",
"telephone_number": "606-886-7635",
"fax_number": "606-886-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAAFAR",
"first_name": "MAZEN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "30466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64304660",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prestonsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.