Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Reza John Hatefi, PAC

Individual provider Physician Assistant · NPI 1114960036

Mr. Reza John Hatefi, PAC is a Physician Assistant in Wake Forest, North Carolina. Qualified in 2000, 26 years ago. Practices with Select Medical Services, PLLC, a 6-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
26
Licensed in
NC
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2001 S Main St
Wake Forest, NC 27587-1649
Phone: (919) 350-0365
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence NC 103020 (NC)

Record details

NPI number1114960036
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 14, 2006
Last updated in NPPESFebruary 25, 2021
Certification dateFebruary 25, 2021
Mailing address2920 Highwoods Blvd, Raleigh, NC 27604-0010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Select Medical Services, Pllc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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