Individual provider Active NPI

Pouria Mossahebi, MD, PHD

  • Vascular & Interventional Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1063919900
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A193658 Issued in CA
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 274-1866
NPI assigned
Apr 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME182916 FL
Vascular & Interventional Radiology Physician 2085R0204X A193658 CA Primary

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 274-1866

Other practice location 1

52 Underwood St
Orlando, FL 32806-1110
Phone (407) 649-6823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240927000251 CA Practitioner - Interventional Radiology 6901265222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Imaging Associates IncGroup PAC ID 1254761315, 242 clinicians

Practice addresses (Care Compare)

10211 Loughton Ave
Bakersfield, CA 93311-4957
Phone (818) 639-2901

1150 M Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone (818) 639-2901

121 Waterford Cir
Rancho Mirage, CA 92270-3100
Phone (818) 639-2901

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (818) 639-2901

317 N Palm Dr
Apt 4C
Beverly Hills, CA 90210-5800
Phone (818) 639-2901

3700 S St
Lakewood, CA 90712-1419
Phone (818) 639-2901

47111 Monroe St
Indio, CA 92201-6739
Phone (818) 639-2901

6601 White Feather Rd
Joshua Tree, CA 92252-6607
Phone (818) 639-2901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193658CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Imaging Associates Inc Vascular & Interventional Radiology CurrentSince Sep 28, 2025 Accepting new patients

Locations

17100 Euclid St
Ste 4004
Fountain Vly, CA 92708
Phone (714) 966-7200

47111 Monroe St
#1112
Indio, CA 92201

Interoperability endpoints

  • Direct secure messaging: pmossahebimd256103@direct.froedtert.com

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.

Hospital & facility affiliations 6

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": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1063919900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-1866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "407-649-6823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSSAHEBI",
        "first_name": "POURIA",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-08",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME182916",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A193658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.