Individual provider Active NPI

Amir Akhavan Azari, M.D.

  • Corneal and Contact Management Optometrist
  • Philadelphia, PA
National Provider Identifier
1801068382
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
MD45090 Issued in PA
Practice address
840 Walnut St
Suit 920
Philadelphia, PA 19107-5109
Phone
(215) 928-3180
NPI assigned
Mar 25, 2008
Last updated
Jan 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X MD45090 PA Primary

Addresses

Primary practice location

840 Walnut St
Suit 920
Philadelphia, PA 19107-5109

Mailing address

840 Walnut St
Suite 920
Philadelphia, PA 19107-5109
Phone (215) 928-3180

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD45090PAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Eyecare, LLC Past Accepting new patients

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, 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": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1801068382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST",
            "address_2": "SUITE 920",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST",
            "address_2": "SUIT 920",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075109",
            "telephone_number": "215-928-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZARI",
        "first_name": "AMIR",
        "middle_name": "AKHAVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "PA",
            "license": "MD45090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.