Camille Eyvazzadeh, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

MD025523E Issued in PA

Practice address

406 Delaware Ave
Bethlehem, PA 18015-1469

Phone

(610) 866-2600

Fax

(610) 861-7640

NPI assigned

Mar 29, 2006

Last updated

Aug 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• Camille Eyvazzadeh MD PC

  dba Eyvazzadeh & Reilly Colon and Rectal Center

  • Colon & Rectal Surgery Physician
  • Bethlehem, PA
  • NPI 1609845544
  Authorized official Same address or phone
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc

  dba St. Luke's General Surgery Miners

  • Surgery Physician
  • Coaldale, PA
  • NPI 1124685425
  NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1801857925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 DELAWARE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151469",
            "telephone_number": "610-866-2600",
            "fax_number": "610-861-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 DELAWARE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151469",
            "telephone_number": "610-866-2600",
            "fax_number": "610-861-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYVAZZADEH",
        "first_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD025523E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR E CAPITAL",
            "identifier": "01047301",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR E HIGHMARK",
            "identifier": "4548",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR E KHP",
            "identifier": "0004548",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Everyday Home Care LLC
• Everyday Home Care LLC (Everyday Home Health Agency)
• Everyday Home Health - Allentown (Everyday Home Health)
• Alexa Ewald
• Jessica Eygnor, DO
• Daniel J. Eyvazzadeh, MD
• Alexia Kayla Fabey, DMD
• Kathleen Faccio, DO
• Eric Faden, M.D.
• Taira Fadler

• Colon & Rectal Surgery Physician in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Colon & Rectal Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.