Individual provider Active NPI

Kourosh Nazari, M.D.

  • Ophthalmology Physician
  • Deland, FL
National Provider Identifier
1881685741
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME80448 Issued in FL
Practice address
801 N Stone St
Deland, FL 32720-3255
Phone
(386) 734-4431
Fax
(386) 738-1045
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME80448 FL Primary

Addresses

Primary practice location

801 N Stone St
Deland, FL 32720-3255

Mailing address

801 N Stone St
Deland, FL 32720-3255
Phone (386) 734-4431

Other practice location 1

5530 Wisconsin Ave Ste 1209
Chevy Chase, MD 20815-4301
Phone (301) 272-9930

Other identifiers 1

IdentifierTypeStateIssuer
265118100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200107002176 DC Practitioner - Ophthalmology 7719942754 Reassigns benefits to 1 organization
I20220728001501 WV Practitioner - Ophthalmology 7719942754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Georgia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martinsburg Eye Associates PLLCGroup PAC ID 8325117575, 3 clinicians
James W Mattern OD, PLLCGroup PAC ID 6800262833, 6 clinicians

Practice addresses (Care Compare)

2002 Professional CT
Martinsburg, WV 25401-8808
Phone (304) 267-4273

3025 Hamaker CT
Suite 101
Fairfax, VA 22031-2229
Phone (703) 876-9630

Merit-based Incentive Payment System (MIPS)

Final score
90.53 of 100Reported as group
Quality
92.86
Improvement activities
40
Cost
77.97

Merit-based Incentive Payment System (MIPS)

Final score
89.62 of 100Reported as group
Quality
92.09
Improvement activities
40
Cost
75.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1309

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martinsburg Eye Associates PLLC Ophthalmology CurrentSince Aug 1, 2022 Accepting new patients
Todd Alan Goodglick, MD, PC Ophthalmology CurrentSince Oct 23, 2022 Accepting new patients
Cumberland Valley Retina Consultants PC Ophthalmology CurrentSince Aug 1, 2022 Accepting new patients
James W Mattern OD, PLLC Ophthalmology CurrentSince Jun 28, 2022 Accepting new patients
Vision One Inc PastSince Jun 18, 2011 Accepting new patients
Parker Eye Center LLC Ophthalmology PastSince Jul 1, 2009 Accepting new patients
Florida Eye Clinic P a Past Accepting new patients
Orlando Ophthalmology Surgery Center LLC PastSince Sep 16, 2011 Accepting new patients
Central Florida Cataract and Laser Surgery Center, Inc. Ophthalmology Past Accepting new patients
Florida Eye Clinic P a Ophthalmology Past Accepting new patients

Locations

5530 Wisconsin Ave
Ste 1209
Chevy Chase, MD 20815
Phone (202) 744-2885

3025 Hamaker Ct
Ste 101
Fairfax, VA 22031
Phone (703) 876-9630

2002 Professional Ct
Martinsburg, WV 25401
Phone (304) 267-4273

Interoperability endpoints

  • Direct secure messaging: knazari@mea.intellechartdirect.net
  • Direct secure messaging: knazari@capitaleyeconsultants.intellechartdirect.net
  • Direct secure messaging: knazari355663@direct.wvuhsdirect.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881685741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203255",
            "telephone_number": "386-734-4431",
            "fax_number": "386-738-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203255",
            "telephone_number": "386-734-4431",
            "fax_number": "386-738-1045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5530 Wisconsin Ave Ste 1209",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208154301",
            "country_code": "US",
            "telephone_number": "301-272-9930",
            "fax_number": "240-556-0379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZARI",
        "first_name": "KOUROSH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2023-03-07",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME80448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265118100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.