Khosrow Rastgar, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA03458300 Issued in NJ

Practice address

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Phone

(609) 441-2147

Fax

(609) 441-2107

NPI assigned

Jul 29, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1881694909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2705",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952705",
            "telephone_number": "609-441-2147",
            "fax_number": "609-441-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-2147",
            "fax_number": "609-441-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASTGAR",
        "first_name": "KHOSROW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA03458300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3816206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ghulam Ali Rahmani, MD
• Cassandra Ramirez, DO
• Virgen Ramos
• Tammer Raouf, DO
• Gretchen Raring, LCSW
• Kokila L. Rathod, APN
• RCG Southern New Jersey, LLC (Fresenius Medical Care Atlantic City)
• Reed Integrative Health, LLC
• James B Regan, MD
• Reliance Medical Group, LLC

• Anatomic Pathology & Clinical Pathology Physician in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.