NPIMap

Individual provider Active NPI

Maryam Hosseini Farahabadi, M.D., M.S.

  • Student in an Organized Health Care Education/Training Program
  • Orange, CA
National Provider Identifier
1114381753
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
200 S Manchester Ave Ste 206
Orange, CA 92868-3226
Phone
(714) 456-6808
NPI assigned
Apr 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X MD2020-0811 NM
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

200 S Manchester Ave Ste 206
Orange, CA 92868-3226

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address SRMC@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210621002627 NM Practitioner - Neurology 5597007054 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

1397 Weimer Rd
Taos, NM 87571-6253
Phone (575) 751-8911

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Apr 26, 2022 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Mar 9, 2022 Accepting new patients
Taos Health Systems Inc Holy Cross Hospital CurrentSince Jul 25, 2024 Accepting new patients
Otero County Hospital Association CurrentSince Apr 26, 2022 Accepting new patients
Unm Medical Group, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Unm Medical Group Inc CurrentSince Jul 1, 2021 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Mar 9, 2022 Accepting new patients
Unm Hospital Past Accepting new patients
Unm Medical Group Inc Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
University of California - Irvine Medical Center Past Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 12

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 7

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": "1460246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1114381753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 206",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683226",
            "telephone_number": "714-456-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSEINI FARAHABADI",
        "first_name": "MARYAM",
        "credential": "M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-10",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NM",
            "license": "MD2020-0811",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SRMC@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "3001 Broadmoor Blvd NE",
            "city": "Rio Rancho",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871442100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.