Reza Fredrick Ghohestani, MD PHD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

N0043 Issued in TX

Practice address

24165 West Ih-10
Suite 102
San Antonio, TX 78257

Phone

(210) 846-5350

Fax

(210) 547-7913

NPI assigned

Feb 11, 2006

Last updated

Nov 9, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Dermatology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: reza.ghohestani.1@12457.direct.athenahealth.com

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.

• Texas Dermatology Institute

  dba Texas Institute of Dermatology, Laser and Cosmetic Surgery

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1598997454
  Medicare reassignment Authorized official
• Texas Derm Institute, PA

  • Medical Specialty Clinic/Center
  • San Antonio, TX
  • NPI 1326580408
  NPD
• Benedetto Dermatology, LLC

  • MOHS-Micrographic Surgery Physician
  • Philadelphia, PA
  • NPI 1972771129
  NPD (past)
• Benedetto Dermatology,LLC

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1811938863
  NPD (past)

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

{
    "created_epoch": "1139616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1902879687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 W INTERSTATE 10",
            "address_2": "SUITE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571114",
            "telephone_number": "210-846-5350",
            "fax_number": "844-819-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 WEST IH-10",
            "address_2": "SUITE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78257",
            "telephone_number": "210-846-5350",
            "fax_number": "210-547-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOHESTANI",
        "first_name": "REZA",
        "middle_name": "FREDRICK",
        "name_prefix": "Prof.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-11",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD427324",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N0043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Ghezzi
• Ghias Jabbour D.D.S ,PLLC
• Shristi Ghimire Adhikari
• Jennifer Ray Ghiselli
• Leon Ghitis, M.D.
• Mahmood Syed Ghori, PHD
• Kathleen Ghosh, CNIM
• Lina Ghosh, MD
• Prabjot Kaur Ghotra
• Ahmadjawid Ghullamjailani

• Dermatology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.