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MISAGH FASAZADEH
NPI 1376177428
Physician Assistant in Great Neck, NY

Active since February 27, 2020PECOS Enrolled
140 S MIDDLE NECK RD APT 2E, GREAT NECK, NY 11021(818) 642-4131 Get Directions Write a Review

NPPES record last updated: July 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2020, Feb 27, 2020 (2 updates tracked since 2020).

About Misagh Fasazadeh NPPES

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

MISAGH FASAZADEH (NPI 1376177428) is an individual physician assistant in Great Neck, New York, licensed in New York (025221) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376177428
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMISAGH FASAZADEH
Location Address140 S MIDDLE NECK RD APT 2EGreat Neck, NY 11021-3738
Mailing Address140 S Middle Neck Rd Apt 2eGreat Neck, NY 11021-3738 · (818) 642-4131
Phone(818) 642-4131
Sole ProprietorYes
Enumeration DateFebruary 27, 2020
Last NPPES UpdateJuly 13, 20202 updates tracked since enumeration
NPPES CertifiedJuly 13, 2020
✔ NPI 1376177428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 025221
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
140 S MIDDLE NECK RD APT 2E, Great Neck, NY 11021
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Misagh Fasazadeh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Misagh Fasazadeh's NPI number?

The NPI number for Misagh Fasazadeh is 1376177428. It was assigned to this individual provider in the NPPES registry on February 27, 2020.

Where is Misagh Fasazadeh located?

Misagh Fasazadeh practices at 140 S Middle Neck Rd Apt 2E, Great Neck, NY 11021. The listed phone number is (818) 642-4131.

What is Misagh Fasazadeh's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Misagh Fasazadeh enrolled in Medicare?

Yes. Misagh Fasazadeh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Misagh Fasazadeh was last updated on July 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.