Kianoosh Dastan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME140120 Issued in FL

Practice address

6200 SW 73Rd St Ste 69
South Miami, FL 33143-4679

Phone

(786) 662-5465

Fax

(786) 662-5334

NPI assigned

Apr 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Miami Inpatient PhysiciansGroup PAC ID 2567429483, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Miami Hospital Hospital, Miami, FL, CCN 100154
• Mariners Hospital Hospital, Tavernier, FL, CCN 101313
• Homestead Hospital Hospital, Homestead, FL, CCN 100125
• Fishermen'S Community Hospital Hospital, Marathon, FL, CCN 101312
• Doctors Hospital Hospital, Coral Gables, FL, CCN 100296

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Miami Inpatient Physicians

  • Internal Medicine Physician
  • South Miami, FL
  • NPI 1346313194
  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Jacksonville Beach, FL
  • NPI 1346287182
  Medicare reassignment NPD
• First Docs PC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1417655465

  FL

  Medicare reassignment NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1427631696
  NPD
• QMC LLC

  • Hospitalist Physician
  • Miami, FL
  • NPI 1003216391
  NPD (past)
• National Health Rehabilitation LLC

  • Physical Medicine & Rehabilitation Physician
  • Edgewater, NJ
  • NPI 1780080218
  NPD (past)

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

• Doctors Hospital, Inc.

  • General Acute Care Hospital
  • Coral Gables, FL
  • NPI 1952351983
  Care Compare affiliation
• Fishermens Health Inc

  • Critical Access Hospital
  • Marathon, FL
  • NPI 1235669110
  Care Compare affiliation
• Homestead Hospital, Inc.

  • General Acute Care Hospital
  • Homestead, FL
  • NPI 1578547865
  Care Compare affiliation
• Mariners Hospital, Inc

  • Critical Access Hospital
  • Tavernier, FL
  • NPI 1518941806
  Care Compare affiliation
• South Miami Hospital Inc

  • General Acute Care Hospital
  • South Miami, FL
  • NPI 1982688230
  Care Compare affiliation

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1124472261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST STE 69",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "786-662-5465",
            "fax_number": "786-662-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST STE 69",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "786-662-5465",
            "fax_number": "786-662-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Locust St",
            "address_2": "Suite 10517",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152195114",
            "country_code": "US",
            "telephone_number": "412-232-5533",
            "fax_number": "412-232-5689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASTAN",
        "first_name": "KIANOOSH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME140120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamad Badi Dabjan
• Dade Psychiatric Associates, P.a.
• Gayle Ann Dakof
• Paul E Damski, MD
• Darrel J Mase Jr MD PA
• Shea Lee Davenport, MA
• David Gerth MD PA
• Jennifer Davidson, OD
• Oliver Quinn Campbell Davidson, MD
• Maylin Davila Perez, DDS

• Internal Medicine Physician in South Miami, FL
• Providers in South Miami, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.