Organization Active NPI

Mathew Mehrdad Moshirfar DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Sarasota, FL
National Provider Identifier
1093083339
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2267 Issued in FL
Legal business name
MATHEW MEHRDAD MOSHIRFAR DPM PA
Practice address
2190 Gulf Gate Dr
Sarasota, FL 34231-4813
Phone
(941) 921-5521
Fax
(941) 927-0609
NPI assigned
Dec 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Dr. Mathew Mehrdad Moshirfar, DPM
Title
Owner
Phone
(941) 921-5521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO2267 FL Primary

Addresses

Primary practice location

2190 Gulf Gate Dr
Sarasota, FL 34231-4813

Mailing address

2190 Gulf Gate Dr
Sarasota, FL 34231-4813
Phone (941) 921-5521

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120112000234 FL Part B Supplier - Clinic/Group Practice 5395912471 Receives reassigned benefits from 1 practitioner
Practice locations: Osprey, FL

National Provider Directory

National Provider Directory

Locations

2190 Gulf Gate Dr
Sarasota, FL 34231
Phone (941) 921-5521

Practitioners & affiliated clinicians

Practitioners 1

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": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1093083339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 GULF GATE DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342314813",
            "telephone_number": "941-921-5521",
            "fax_number": "941-927-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 GULF GATE DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342314813",
            "telephone_number": "941-921-5521",
            "fax_number": "941-927-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW MEHRDAD MOSHIRFAR DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "MOSHIRFAR",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_middle_name": "MEHRDAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-921-5521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.