Individual provider Active NPI

Mohammad Hossein Gharavi, MD

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1013050939
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME111254 Issued in FL
Practice address
51 S Main Ave
Suite 318
Clearwater, FL 33765-3952
Phone
(727) 572-6261
Fax
(727) 443-2501
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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 ME111254 FL Primary

Addresses

Primary practice location

51 S Main Ave
Suite 318
Clearwater, FL 33765-3952

Mailing address

51 S Main Ave
Suite 318
Clearwater, FL 33765-3952
Phone (727) 572-6261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160706000428 FL Practitioner - Pain Management 6709973522 Practice locations: Clearwater, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17943MDMDPharmacist
ME111254FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Care Management of Clearwater, LLC Past Accepting new patients

Organizations & group practices 1

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1013050939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE",
            "address_2": "SUITE 318",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653952",
            "telephone_number": "727-572-6261",
            "fax_number": "727-443-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE",
            "address_2": "SUITE 318",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653952",
            "telephone_number": "727-572-6261",
            "fax_number": "727-443-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHARAVI",
        "first_name": "MOHAMMAD",
        "middle_name": "HOSSEIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.