Individual provider Active NPI

Farrokh Khajavi-Noori, MD

  • Psychiatry Physician
  • Stoneham, MA
National Provider Identifier
1073567749
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34309 Issued in MA
Practice address
3 Woodland Rd Ste 418
Ste 418
Stoneham, MA 02180-1714
Phone
(781) 662-6213
Fax
(781) 665-9860
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34309 MA Primary

Addresses

Primary practice location

3 Woodland Rd Ste 418
Ste 418
Stoneham, MA 02180-1714

Mailing address

3 Woodland Rd
#418
Stoneham, MA 02180-1714
Phone (781) 662-6213

Other identifiers 1

IdentifierTypeStateIssuer
2002019MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20051105000203 MA Practitioner - PsychiatryPractitioner - Neurology 4082632237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3 Woodland Rd
Suite 418
Stoneham, MA 02180-1714
Phone (781) 662-6213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34309MAMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: fkhajavi@elincdirect.org

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1073567749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "#418",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801714",
            "telephone_number": "781-662-6213",
            "fax_number": "781-665-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD STE 418",
            "address_2": "STE 418",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801714",
            "telephone_number": "781-662-6213",
            "fax_number": "781-665-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAJAVI-NOORI",
        "first_name": "FARROKH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "34309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002019",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.