Camellia Mazloomdoost, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25685 Issued in KY

Practice address

101 N Eagle Creek Dr
Lexington, KY 40509-1806

Phone

(859) 275-4878

NPI assigned

Jan 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Camellia Shirazi Mazloomdoost Other name

Medicare fee-for-service enrollment

Enrolled in KY

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

Psychiatry

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Manoochehr Mazloomdoost PSCGroup PAC ID 8729983218, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Manoochehr Mazloomdoost PSC

  dba Wellward Regenerative Medicine

  • Pain Medicine (Anesthesiology) Physician
  • Lexington, KY
  • NPI 1770555492
  Medicare reassignment Care Compare group NPD
• Manoochehr Mazloomdoost P S C

  dba Wellward

  • Pain Medicine (Anesthesiology) Physician
  • Corbin, KY
  • NPI 1720110182
  NPD
• Alpha Counseling & Management, Inc.

  • Nursing Facility/Intermediate Care Facility
  • Frenchburg, KY
  • NPI 1689751083
  NPD (past)
• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stanton, KY
  • NPI 1043250095
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1952372419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091806",
            "telephone_number": "859-275-4878",
            "fax_number": "859-276-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091806",
            "telephone_number": "859-275-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Cumberland Falls HWY STE 5",
            "address_purpose": "LOCATION",
            "city": "Corban",
            "state": "KY",
            "postal_code": "40701",
            "country_code": "US",
            "telephone_number": "859-275-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Shaker Dr",
            "address_2": "Ste 101 Pain Management Medicine",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40504",
            "country_code": "US",
            "telephone_number": "859-275-4878",
            "fax_number": "859-276-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZLOOMDOOST",
        "first_name": "CAMELLIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "25685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000049975",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64256852",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMELLIA",
            "last_name": "MAZLOOMDOOST",
            "middle_name": "SHIRAZI",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chandler Ryan Maze
• Joe Maze, RPH.
• Karleigh Maze
• Suze Marie Maze, LCSW, CCGC, CEAP
• Whitley Ashton Maze, CRNA
• Danesh Mazloomdoost, MD
• Manoochehr Mazloomdoost, MD
• Alison Mazurak
• Alberto Mazzoleni, M.D.
• Emmy Obinna Mbagwu

• Psychiatry Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.