1. Home
  2. Directory
  3. California
  4. San Diego
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

PAUL CYRUS KASRAZADEH
NPI 1124777024
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since March 20, 2022PECOS Enrolled
6911 CONVOY CT FL 2, SAN DIEGO, CA 92111(858) 573-6409 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Paul Cyrus Kasrazadeh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAUL CYRUS KASRAZADEH (NPI 1124777024) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1124777024
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePAUL CYRUS KASRAZADEH
Location Address6911 CONVOY CT FL 2San Diego, CA 92111-1014
Mailing Address6911 Convoy Ct Fl 2San Diego, CA 92111-1014
Phone(858) 573-6409
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 20, 2022
Last NPPES UpdateJuly 25, 2022
NPPES CertifiedMarch 20, 2022
✔ NPI 1124777024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6911 CONVOY CT FL 2, San Diego, CA 92111
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Cyrus Kasrazadeh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971950338
PECOS Enrollment IDI20251031000070
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Paul Kasrazadeh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
4.6 mi
Health Maintenance Organization
1288 CAMINO DEL RIO N
San Diego, CA 92108
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1023425972 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVEN BENNETT MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (858) 573-6400
DR. REBECCA EARLY MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (858) 573-6400
DR. IAN RUSSELL DO
Family Medicine
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (858) 573-6400
DR. JAMISON MARIE STOUT MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (833) 574-2273
JACQUES LOWE MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (619) 528-5164
JEMIMA DEGAMO MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (853) 574-2273
JESSICA DONG
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (833) 574-2273
AIDAN ANNE GALATI MD
Student in an Organized Health Care Education/Training Program
6911 CONVOY CT FL 2
SAN DIEGO, CA 92111
San Diego County (833) 574-2273

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Kasrazadeh's NPI number?

The NPI number for Paul Kasrazadeh is 1124777024. It was assigned to this individual provider in the NPPES registry on March 20, 2022.

Where is Paul Kasrazadeh located?

Paul Kasrazadeh practices at 6911 Convoy Ct Fl 2, San Diego, CA 92111. The listed phone number is (858) 573-6409.

What is Paul Kasrazadeh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Paul Kasrazadeh enrolled in Medicare?

Yes. Paul Kasrazadeh is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Paul Kasrazadeh's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Kasrazadeh reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Paul Kasrazadeh's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Paul Kasrazadeh was last updated on July 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.