Individual provider Active NPI

Forouz Jowkar, PA-C

  • Physician Assistant
  • Santa Fe, NM
National Provider Identifier
1942446273
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2008-0051 Issued in NM
Practice address
1925 Aspen Dr
#100B
Santa Fe, NM 87505-5579
Phone
(505) 424-9172
Fax
(505) 438-1814
NPI assigned
Dec 16, 2008
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2008-0051 NM Primary

Addresses

Primary practice location

1925 Aspen Dr
#100B
Santa Fe, NM 87505-5579

Mailing address

2019 Galisteo St
Santa Fe, NM 87505-2143
Phone (505) 424-9172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141031001490 NM Order and Referring Only - Physician Assistant 9830318906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2008-0051NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forouz Jowkar LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1942446273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052143",
            "telephone_number": "505-424-9172",
            "fax_number": "505-438-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ASPEN DR",
            "address_2": "#100B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055579",
            "telephone_number": "505-424-9172",
            "fax_number": "505-438-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOWKAR",
        "first_name": "FOROUZ",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2008-0051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.