Organization Active NPI

Nasser Eftekhari MD, PA

  • Physical Medicine & Rehabilitation Physician
  • Miami, FL
National Provider Identifier
1801150842
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME0050316 Issued in FL
Legal business name
NASSER EFTEKHARI MD, PA
Practice address
6301 SW 112TH St
Miami, FL 33156-4850
Phone
(305) 206-4726
NPI assigned
Jun 25, 2012
Last updated
Jun 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Dr. Nasser Eftekhari, MD,PANPI 1356442776
Title
Owner
Phone
(305) 206-4726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME0050316 FL Primary

Addresses

Primary practice location

6301 SW 112TH St
Miami, FL 33156-4850

Mailing address

6301 SW 112TH St
Miami, FL 33156-4850
Phone (305) 206-4726

Other identifiers 1

IdentifierTypeStateIssuer
0594466MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000567 FL Part B Supplier - Clinic/Group Practice 1052577681 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1801150842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 SW 112TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331564850",
            "telephone_number": "305-206-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 SW 112TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331564850",
            "telephone_number": "305-206-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSER EFTEKHARI MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "EFTEKHARI",
        "authorized_official_first_name": "NASSER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-206-4726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,PA"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME0050316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0594466",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.