Mohammed Taghi Rezai, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A14895 Issued in CA

Practice address

455 E Thousand Oaks Blvd Ste B
Thousand Oaks, CA 91360-5800

Phone

(818) 232-5788

NPI assigned

Jun 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 28, 2020 through Dec 28, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• M T Rezai PC

  • Primary Care Clinic/Center
  • Malibu, CA
  • NPI 1437791704

  Single Specialty

  NPD Authorized official
• Breathe Health LLC

  dba Breathe Hyperbarics

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Thousand Oaks, CA
  • NPI 1134960925

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1013399195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E THOUSAND OAKS BLVD STE B",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605800",
            "telephone_number": "818-232-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E THOUSAND OAKS BLVD STE B",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605800",
            "telephone_number": "818-232-5788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3184 Churn Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960022122",
            "country_code": "US",
            "telephone_number": "530-768-2446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZAI",
        "first_name": "MOHAMMED",
        "middle_name": "TAGHI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "20A14895",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "20A14895",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Reveles
• Revlin Therapy Services
• Francisco Ivan Reyes, MD
• Krystal Reyes
• Olivya Reyes
• Alex Lee Rhodes, LCSW
• Brian J. Rice, BCBA
• Jonathan Rice, PAC
• Richard Hoberman, M.D., Inc.
• Richard Lessman, M.D., Inc.

• Family Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.