Kamran Goudarzi, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25503 Issued in NC

Practice address

710 Military Cutoff Rd Ste 130
Wilmington, NC 28405-2382

Phone

(910) 769-3084

Fax

(910) 769-6023

NPI assigned

Mar 22, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

General Surgery

Education

Other, 1978

Medicare assignment

May accept Medicare assignment

Group practices

Kamran Goudarzi Surgical Practice PCGroup PAC ID 5597014993, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgoudarzi1246403@direct.novanthealth.org

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.

• Kamran Goudarzi Surgical Practice PC

  • Surgery Physician
  • Wilmington, NC
  • NPI 1013494400
  Medicare reassignment Care Compare group NPD Authorized official
• Wallace Urgent Care LLC

  • Internal Medicine Physician
  • Wallace, NC
  • NPI 1841259025
  NPD Authorized official
• Rocky Point Urgent Care LLC

  • Clinic/Center
  • Rocky Point, NC
  • NPI 1265491435
  NPD
• Clinton Urgent Care LLC

  • Urgent Care Clinic/Center
  • Clinton, NC
  • NPI 1598877540
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health New Hanover Regional Medical Center LLC

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1972562593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD STE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-769-3084",
            "fax_number": "910-769-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF RD STE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-769-3084",
            "fax_number": "910-769-6023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Olde Waterford Way Ste 305",
            "address_purpose": "LOCATION",
            "city": "Leland",
            "state": "NC",
            "postal_code": "284514179",
            "country_code": "US",
            "telephone_number": "910-726-3737",
            "fax_number": "910-762-3712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUDARZI",
        "first_name": "KAMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "25503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936503",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Goshen Medical Center Incorporated
• Goshen Medical Center Incorporated
• Benjamin Robert Gosselin, DDS
• Bernard Gottschalk, MD
• Hormoze A Goudarzi, M.D.
• Cailyn Grace Gould
• Martin Scott Gould, DDS, MS
• Ashley Elizabeth Gousios, MS, RDN, LDN, CNSC
• Alyssa Gowdy, PA-C
• Grant Gowing

• Surgery Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.