Organization Active NPI

Hossein Khazei Tabari LTD

  • Nephrology Physician
  • Bogalusa, LA
National Provider Identifier
1912055468
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
06731R Issued in LA
Legal business name
HOSSEIN KHAZEI TABARI LTD
Practice address
1616 S Columbia St
Suite E
Bogalusa, LA 70427-5880
Phone
(985) 735-7810
Fax
(985) 732-0495
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Authorized official

Name
Dr. Hossein K Tabari, M.D.NPI 1619032141
Title
Physician
Phone
(985) 735-7810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 06731R LA Primary

Addresses

Primary practice location

1616 S Columbia St
Suite E
Bogalusa, LA 70427-5880

Mailing address

1616 S Columbia St
Suite E
Bogalusa, LA 70427-5880
Phone (985) 735-7810

Other identifiers 2

IdentifierTypeStateIssuer
06731ROtherLALA STATE LICENSE
1350443MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116000047 LA Part B Supplier - Clinic/Group Practice 5496719841 Receives reassigned benefits from 1 practitioner
Practice locations: Bogalusa, LA

National Provider Directory

National Provider Directory

Locations

1616 S Columbia St
Ste E
Bogalusa, LA 70427
Phone (504) 735-8382

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1912055468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S COLUMBIA ST",
            "address_2": "SUITE E",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704275880",
            "telephone_number": "985-735-7810",
            "fax_number": "985-732-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S COLUMBIA ST",
            "address_2": "SUITE E",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704275880",
            "telephone_number": "985-735-7810",
            "fax_number": "985-732-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSSEIN KHAZEI TABARI LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "TABARI",
        "authorized_official_first_name": "HOSSEIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "985-735-7810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "06731R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA STATE LICENSE",
            "identifier": "06731R",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350443",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.