Jamal Mahdavian, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

207514-1 Issued in NY

Practice address

40 Hurley Ave Suite 5
Kingston, NY 12401

Phone

(845) 338-9488

Fax

(845) 338-6774

NPI assigned

Jan 18, 2007

Last updated

Dec 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

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

General SurgeryAlso: Colorectal Surgery (Proctology)

Education

Albany Medical College of Union University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westchester Medical Center Advanced Physician Services PCGroup PAC ID 3173660776, 879 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/
• Direct secure messaging: jamal.mahdavian@wmchealth.cernerdirect.com
• Direct secure messaging: mahdavianj@hiemail.healtheconnections.org

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.

• Healthalliance Hospital Marys Avenue Campus

  • Psychiatric Hospital Unit
  • Kingston, NY
  • NPI 1285601237

  Corporate Director

  CMS ownership
• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392
  Medicare reassignment Care Compare group NPD
• Mahdavian & Mahdavian LLP

  • Surgery Physician
  • Kingston, NY
  • NPI 1770687113
  Authorized official Same address or phone
• Westchester Medical Center Advanced Physician Services PC

  • Anesthesiology Physician
  • Valhalla, NY
  • NPI 1740687458
  NPD
• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599
  NPD (past)
• Mid-Hudson Family Health Institute

  • Family Medicine Physician
  • New Paltz, NY
  • NPI 1326093642
  NPD (past)
• Westchester Medical Center

  • General Acute Care Hospital
  • Valhalla, NY
  • NPI 1023286184
  NPD (past)

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

• Healthalliance Hospital Marys Avenue Campus

  • General Acute Care Hospital
  • Kingston, NY
  • NPI 1932182599
  Care Compare affiliation

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1144373929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE SUITE 5",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-9488",
            "fax_number": "845-338-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE SUITE 5",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-9488",
            "fax_number": "845-338-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDAVIAN",
        "first_name": "JAMAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "207514-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ9902",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01770869",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JAMAL.MAHDAVIAN@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "40 hurley ave suite 5",
            "city": "kingston",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JAMAL.MAHDAVIAN@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "40 hurley ave suite 5",
            "city": "kingston",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karrah Madden
• Timothy Madden, M.D.
• Suchee Madhusudan, MD
• Lisa A. Maffucci, D.C.
• Mahdavian & Mahdavian LLP
• Colleen M Maher, LMSW
• Matthew John Maher, PHD, LMHC
• Susan Mary Mahoney, LMSW
• Shannon Paige Mahony
• Adriane Maier

• Surgery Physician in Kingston, NY
• Providers in Kingston, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.