Shahab Mokhtare, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NV13663 Issued in NV

Practice address

9811 W Charleston Blvd
Suite 2441
Las Vegas, NV 89117-7528

Phone

(702) 953-1576

NPI assigned

Jul 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shahab Mokhtare IncGroup PAC ID 3274857065, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assured Home Health Agency Home health agency, Las Vegas, NV, CCN 297243
• Shining Light Hospice Hospice, Las Vegas, NV, CCN 291600
• Siena Hospice Hospice, Las Vegas, NV, CCN 291611

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Shining Light LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1801481676

  5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Siena Hospice LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1952982670

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

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.

• Shahab Mokhtare Inc

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1639576820
  Medicare reassignment Care Compare group NPD Authorized official
• Shining Light LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1801481676

  Family Medicine

  NPD
• Siena Hospice LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1952982670

  Family Medicine

  NPD

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

• Avm Corp, LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1992144042
  Care Compare affiliation
• Shining Light LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1801481676
  Care Compare affiliation
• Siena Hospice LLC

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1952982670
  Care Compare affiliation

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1093913378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD STE 2-441",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "702-420-7704",
            "fax_number": "702-420-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD",
            "address_2": "SUITE 2441",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177528",
            "telephone_number": "702-953-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKHTARE",
        "first_name": "SHAHAB",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "NV13663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LIC",
            "identifier": "LL1758",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reza Mojtabavi, MD
• Ohidul Mojumder
• Yaebum Mok
• Jamila Mokhtar
• Maryam Mokhtare
• Neda Mokhtarifard
• Rochelle Mokiao, BA
• Sabita Moktan Sheikhai, M.D.
• Yolanda Mola Alvarez
• Reinier Mola Gandol

• Family Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.