Individual provider Active NPI

Kianoush Cheybani, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1013901578
Registry record updated May 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30615 Issued in AZ
Practice address
9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258-4583
Phone
(480) 455-3000
Fax
(866) 819-6115
NPI assigned
Sep 9, 2005
Last updated
May 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30615 AZ Primary

Addresses

Primary practice location

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258-4583

Mailing address

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258-4583
Phone (480) 455-3000

Other identifiers 1

IdentifierTypeStateIssuer
687634-01MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100720000213 AZ Practitioner - Internal Medicine 4385776897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aia Hospitalists LLCGroup PAC ID 3375583636, 51 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7693
Phone (480) 961-2303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30615AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
4C Medical Group PLC Internal Medicine CurrentSince Nov 1, 2015 Accepting new patients
4C Medical Group PLC CurrentSince Nov 1, 2015 Accepting new patients
Aia Hospitalists LLC Internal Medicine CurrentSince Jun 25, 2019 Accepting new patients

Locations

330 S Pinnule Cir
Mesa, AZ 85206
Phone (480) 981-0687

4530 E Muirwood Dr
Ste 105
Phoenix, AZ 85048
Phone (480) 961-2303

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

9590 E Ironwood Square Dr
Ste 125
Scottsdale, AZ 85258
Phone (480) 272-6400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464566400000",
    "number": "1013901578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 E IRONWOOD SQUARE DR",
            "address_2": "STE 125",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584583",
            "telephone_number": "480-455-3000",
            "fax_number": "866-819-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 E IRONWOOD SQUARE DR",
            "address_2": "STE 125",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584583",
            "telephone_number": "480-455-3000",
            "fax_number": "866-819-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEYBANI",
        "first_name": "KIANOUSH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2016-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "30615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687634-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.