Individual provider Active NPI

Mostafa Mirhaidari, D.O.

  • Family Medicine Physician
  • Uniontown, OH
National Provider Identifier
1003826819
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-00-8184 M Issued in OH
Practice address
3515 Massillon Rd Ste 250
Uniontown, OH 44685
Phone
(330) 896-5651
Fax
(330) 896-5685
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-00-8184 M OH Primary

Addresses

Primary practice location

3515 Massillon Rd Ste 250
Uniontown, OH 44685

Mailing address

3515 Massillon Rd Ste 250
Uniontown, OH 44685-7854
Phone (330) 896-5651

Other practice location 1

152 N Broadway St
Suite 100
New Philadelphia, OH 44663-2665
Phone (330) 364-8884

Other practice location 2

152 N Broadway St
Suite 100
New Philadelphia, OH 44663-2665
Phone (330) 364-8884

Other identifiers 1

IdentifierTypeStateIssuer
2544830MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20050711000085 OH Practitioner - Family Practice 6608802988 Reassigns benefits to 2 organizations
Practice locations: New Philadelphia, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Hospice of Northeast Ohio, LLC CurrentSince Nov 6, 2022 Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Mirhaidari Family Practice Family Medicine PastSince May 10, 2017 Accepting new patients
Mostafa Mirhaidari, D.O. Family Medicine PastSince Jan 1, 1990 Accepting new patients
The Union Hospital Association Past Accepting new patients
Morteza Mirhaidari D P M PastSince May 10, 2017 Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

3515 Massillon Rd
Ste 250
Green, OH 44685
Phone (330) 734-6015

3743 Boettler Oaks Dr
Ste E
Green, OH 44685
Phone (330) 899-9100

7350 Industrial Park Blvd
Mentor, OH 44060
Phone (216) 732-9480

7206 Market St
Ste A
Youngstown, OH 44512
Phone (330) 726-3379

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1003826819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 MASSILLON RD STE 250",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857854",
            "telephone_number": "330-896-5651",
            "fax_number": "330-896-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 MASSILLON RD STE 250",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "44685",
            "telephone_number": "330-896-5651",
            "fax_number": "330-896-5685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 N Broadway St",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "New Philadelphia",
            "state": "OH",
            "postal_code": "446632665",
            "country_code": "US",
            "telephone_number": "330-364-8884",
            "fax_number": "330-602-5747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "152 N Broadway St",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "New Philadelphia",
            "state": "OH",
            "postal_code": "446632665",
            "country_code": "US",
            "telephone_number": "330-364-8884",
            "fax_number": "330-602-5747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRHAIDARI",
        "first_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-8184 M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2544830",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, OH

Sources for this page

Verify at the official NPI Registry.