Individual provider Active NPI

Ghassem Khan Atashirang, OD PHD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1801011937
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
03756 Issued in TX
Practice address
2130 S Buckner Blvd
Dallas, TX 75227-8601
Phone
(214) 381-1700
Fax
(214) 381-1497
NPI assigned
Apr 16, 2007
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 03756 TX
Occupational Vision Optometrist 152WX0102X 03756 TX
Optometrist 152W00000X 03756 TX Primary

Addresses

Primary practice location

2130 S Buckner Blvd
Dallas, TX 75227-8601

Mailing address

623 Courageous Drive
Rockwell, TX 75032-5769
Phone (972) 772-1800

Other identifiers 3

IdentifierTypeStateIssuer
526446OtherTXOE NUMBER OPTOMETIC EDUCA
910075OtherTXEYE MED
GOOOE78S6MedicaidTX

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03756TXMDOccupational Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyeconic Vision, PLLC Optometrist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1801011937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 COURAGEOUS DRIVE",
            "city": "ROCKWELL",
            "state": "TX",
            "postal_code": "750325769",
            "telephone_number": "972-772-1800",
            "fax_number": "972-772-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 S BUCKNER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752278601",
            "telephone_number": "214-381-1700",
            "fax_number": "214-381-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATASHIRANG",
        "first_name": "GHASSEM",
        "middle_name": "KHAN",
        "name_prefix": "Dr.",
        "credential": "OD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "03756",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TX",
            "license": "03756",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "03756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OE NUMBER OPTOMETIC EDUCA",
            "identifier": "526446",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "910075",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GOOOE78S6",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.