Michael Jafarzadeh, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

37515 Issued in TX

Practice address

1412 Main St
Ste. 320
Dallas, TX 75202

Phone

(214) 760-1964

Fax

(214) 760-9505

NPI assigned

Jan 11, 2017

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

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Assessment Group, LLC

  • Psychologist
  • Dallas, TX
  • NPI 1316211436
  Medicare reassignment NPD Authorized official
• Susan Talmage, PHD, PA

  • Psychologist
  • Dallas, TX
  • NPI 1639678113
  NPD (past)

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1922544113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MAIN ST",
            "address_2": "STE. 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752024014",
            "telephone_number": "214-760-1964",
            "fax_number": "214-760-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MAIN ST",
            "address_2": "STE. 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75202",
            "telephone_number": "214-760-1964",
            "fax_number": "214-760-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFARZADEH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-11",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard G Jaeckle, M.D.
• Nelson Jaeggli, M.D.
• Noggy David Jaen, FNP
• Brian Jafari
• Carley Jafari, BCBA
• Asra Jaffar
• Jack Jaffe, PSYD
• Samantha Hope Jaffe, M.A., LMFT
• Jay Bennett Jaffee, M.D.
• Syeda Uzma Jaffery, M.D.

• Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.