Individual provider Active NPI

Mohsin Raza

  • Psychiatry Physician
  • Orange Park, FL
National Provider Identifier
1790244689
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C1-0025558 Issued in DE
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone
(904) 639-2000
Fax
(904) 639-2015
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X C1-0025558 DE Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5156

Mailing address

2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone (904) 639-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20230501001552 DE Practitioner - Psychiatry 9931436904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uhs of Dover LLCGroup PAC ID 4486653151, 9 clinicians

Practice addresses (Care Compare)

725 Horsepond Rd
Dover, DE 19901-7232
Phone (302) 741-0140

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Dover LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

725 Horsepond Rd
Dover, DE 19901
Phone (302) 741-0140

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 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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1790244689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "MOHSIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C1-0025558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.