Fawad Zadran, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34832 Issued in CA

Practice address

1113 Highway 49
San Andreas, CA 95249

Phone

(209) 755-1480

Fax

(209) 674-6190

NPI assigned

May 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Southern California College of Optometry, 2021

Medicare assignment

May accept Medicare assignment

Group practices

M a C T Health Board IncorporatedGroup PAC ID 8325936974, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: fawad.zadran.p1@direct.macthealth.nextgenshare.com

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.

• M a C T Health Board Incorporated

  • Federally Qualified Health Center (FQHC)
  • San Andreas, CA
  • NPI 1366519431

  TX

  Medicare reassignment Care Compare group
• M a C T Health Board, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Sutter Creek, CA
  • NPI 1417741869

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1891360111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 CRESTLINE CIR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627224",
            "telephone_number": "916-850-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 HIGHWAY 49",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-755-1480",
            "fax_number": "209-674-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13975 Mono Way Ste G",
            "address_purpose": "LOCATION",
            "city": "Sonora",
            "state": "CA",
            "postal_code": "953702824",
            "country_code": "US",
            "telephone_number": "209-533-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5192 Hospital Rd.",
            "address_purpose": "LOCATION",
            "city": "Mariposa",
            "state": "CA",
            "postal_code": "95338",
            "country_code": "US",
            "telephone_number": "209-742-6144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Highway Junction 371 Route 9 PMB 358",
            "address_purpose": "LOCATION",
            "city": "Crownpoint",
            "state": "NM",
            "postal_code": "87313",
            "country_code": "US",
            "telephone_number": "505-786-6249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZADRAN",
        "first_name": "FAWAD",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Roxanne Wright, PEER SUPPORT
• Kellie Fronk Wright, PT
• Yosemite Pathology Medical Group, Inc.
• Yosemite Valley Medical Services a Medical Corporation
• Daryle R Yount, LMFT
• Shva Ziv
• Arianna Zylstra, EMT

• Optometrist in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.