Individual provider Active NPI

Mohammad Reza Moienafshari, M.D.

  • Internal Medicine Physician
  • Greenwich, CT
National Provider Identifier
1154396893
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
039581 Issued in CT
Practice address
644 W Putnam Ave
Greenwich, CT 06830-6088
Phone
(203) 210-2810
Fax
(203) 210-2811
NPI assigned
Feb 17, 2006
Last updated
Jan 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 302563 NY
Internal Medicine Physician 207R00000X 039581 CT Primary

Addresses

Primary practice location

644 W Putnam Ave
Greenwich, CT 06830-6088

Mailing address

2700 Westchester Ave
Purchase, NY 10577-2547
Phone (914) 607-5730

Other identifiers 1

IdentifierTypeStateIssuer
1154396893MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051228000409 CT Practitioner - Internal Medicine 1850287434 Reassigns benefits to 1 organization
I20200205002158 NY Practitioner - Internal Medicine 1850287434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

644 W Putnam Ave
Greenwich, CT 06830-6088
Phone (203) 622-0303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039581CTMDInternal Medicine Physician
302563NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Apr 27, 2023 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Apr 27, 2023 Accepting new patients
The Westchester Medical Group PC CurrentSince Jan 6, 2020 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Westchester Medical Group, P.C. Internal Medicine CurrentSince Jan 6, 2020 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

644 W Putnam Ave
Greenwich, CT 06830
Phone (203) 210-2880

1281 E Main St
Stamford, CT 06902
Phone (203) 325-4087

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

2700 Westchester Ave
Purchase, NY 10577
Phone (914) 607-5730

108 S Ridge St
Rye Brook, NY 10573
Phone (914) 219-0187

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

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

Interoperability endpoints

  • Direct secure messaging: mmoienafshari@hiemail.healtheconnections.org
  • Direct secure messaging: mohammad.moienafshari.1@21260.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1154396893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772547",
            "telephone_number": "914-607-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 W PUTNAM AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306088",
            "telephone_number": "203-210-2810",
            "fax_number": "203-210-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOIENAFSHARI",
        "first_name": "MOHAMMAD REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "302563",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "039581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154396893",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.