Organization Active NPI

Mostafavi MD PA

  • Vascular Surgery Physician
  • Boynton Beach, FL
National Provider Identifier
1033238449
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MOSTAFAVI MD PA
Practice address
1880 N Congress Ave
Suite 301
Boynton Beach, FL 33426-8671
Phone
(561) 424-5004
Fax
(561) 424-2689
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Authorized official

Name
Armaghan A Mostafavi, MDNPI 1396718722
Title
Owner
Phone
(561) 424-5004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1880 N Congress Ave
Suite 301
Boynton Beach, FL 33426-8671

Mailing address

1880 N Congress Ave
Suite# 301
Boynton Beach, FL 33426
Phone (561) 424-5004

Other identifiers 1

IdentifierTypeStateIssuer
255005900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070713000010 FL Part B Supplier - Clinic/Group Practice 0941300453 Receives reassigned benefits from 1 practitioner
Practice locations: Boynton Beach, FL

National Provider Directory

National Provider Directory

Locations

1880 N Congress Ave
Ste 301
Boynton Beach, FL 33426
Phone (561) 424-5004

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1033238449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 N CONGRESS AVE",
            "address_2": "SUITE# 301",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-424-5004",
            "fax_number": "561-424-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 N CONGRESS AVE",
            "address_2": "SUITE 301",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268671",
            "telephone_number": "561-424-5004",
            "fax_number": "561-424-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSTAFAVI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "MOSTAFAVI",
        "authorized_official_first_name": "ARMAGHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-424-5004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255005900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.