DR. KHASHAYAR EBRAHIMZADEH (NPI# 1770144016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770144016 |
| Entity Type | Individual |
| Full Name | DR. KHASHAYAR EBRAHIMZADEH |
| Credential | MD |
| Practice Address |
5303 S Cedar St Ste 205 Lansing MI 48911-3800 |
| Mailing Address |
Po Box 30161 Lansing MI 48909-7661 |
| Practice Telephone | 5178874305 |
| Mailing Telephone | 5178874305 |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4351045098 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4351045098 | 05 |
| Street Address |
5303 S CEDAR ST STE 205 |
| City | LANSING |
| State | MI |
| Zip Code | 48911-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407386329 | Ambria Faith Jump | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2017-06-13 |
| 1134738230 | Alina Leshchiner | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-07-24 |
| 1679182778 | Ekaterina Iausheva | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-07-24 |
| 1487272266 | Lara Saoud Al-agailat | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-07-08 |
| 1902423767 | Muhammad Sheraz Raza | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-06-28 |
| 1952927394 | Joe-ann Lourens | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-06-22 |
| 1104442904 | Savannah Gowan | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-06-18 |
| 1982229365 | Ravleen Kaur Saini | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2020-06-11 |
| 1194377234 | Hinna Singh | Student in an Organized Health Care Education/Training Program | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2019-07-09 |
| 1730731878 | Sara Mohamed | Student in an Organized Health Care Education/Training Program | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2019-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943603 | Promissa Personalized Care Services LLC | Assisted Living Facility | 200 E Edgewood Blvd, Lansing, MI 48911 | 2020-05-07 |
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1447713946 | Fadi Nuseibeh | Pharmacist | 3955 Patient Care Drive, Pharmacy, Lansing, MI 48911 | 2019-04-11 |
| 1740704543 | Kyle Lardie | Dental Hygienist | Care Free Medical and Dental 5135 S Pennsylvania Ave, Lansing, MI 48911 | 2017-08-02 |
| 1124549845 | Joash Michael Charles | Behavior Technician | 3720 Richmond Street, Lansing, MI 48911 | 2017-07-03 |
| 1205212164 | Benjamin Curtis Neal | Dentist | 5601 S Cedar St., Lansing, MI 48911 | 2015-08-03 |
| 1376927608 | Heather Lamb | Home Health | 2919 Risdale St, Lansing, MI 48911 | 2015-07-16 |
| 1669861712 | Lucas James Evan Joseph Bila | Licensed Practical Nurse | 2204 S. Wadsworth Dr, Lansing, MI 48911 | 2015-01-13 |
| 1649695271 | Aaron James Hart | Occupational Therapist | 3960 Patient Care Dr Ste 117, Lansing, MI 48911 | 2014-02-18 |
| 1831465871 | Los Equipment Corporation | Dentist | 6810 S. Cedar St, Suite 5, Lansing, MI 48911 | 2012-03-23 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1740790146 | Theo Pediatric Health | Pediatrics | 1219 1/2 Turner St, Lansing, MI 48906-4341 | 2017-10-11 |
| 1891216834 | Ahmad Khalil | Pediatrics | 1200 E Michigan Ave Ste 205, Lansing, MI 48912-1800 | 2017-06-29 |
| 1407386329 | Ambria Faith Jump | Pediatrics | 5303 S Cedar St Ste 205, Lansing, MI 48911-3800 | 2017-06-13 |
| 1114478419 | Jerry Joe Evans | Pediatrics | 610 W Ottawa St, Apt. 906, Lansing, MI 48933-1056 | 2016-10-21 |
| 1730561366 | Christine Sims | Pediatrics | 7335 Westshire Dr Ste 102, Lansing, MI 48917-9703 | 2015-06-19 |
| 1548609225 | Stephanie Anne Klein | Pediatrics | 2414 Lake Lansing Road, Lansing, MI 48912 | 2013-06-17 |
| 1679882005 | Bhagya Mysore Venkatesh | Pediatrics | 901 East Michigan Avenue, Lansing, MI 48910 | 2010-10-04 |
| 1205147451 | Erica Lillian Still | Pediatrics | 15673 Wood Rd, Lansing, MI 48906-1740 | 2010-06-22 |
| 1083877344 | Sabrina Diane Dinkha | Pediatrics | 13750 S Sedona Parkway, Suite 2, Lansing, MI 48906 | 2008-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.