Shahir Okhovat-Ghahfarokhi, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01090394A Issued in IN

Practice address

1627 E Bristol St
Elkhart, IN 46514-3817

Phone

(574) 262-0313

Fax

(574) 389-4879

NPI assigned

Aug 5, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shahir.okhovat-ghahfarokhi.1@18277.direct.athenahealth.com

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.

• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1194134080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143817",
            "telephone_number": "574-262-0313",
            "fax_number": "574-389-4879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N East St",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "IL",
            "postal_code": "624502432",
            "country_code": "US",
            "telephone_number": "618-395-5222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2120 Rieth Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265867",
            "country_code": "US",
            "telephone_number": "574-262-0313",
            "fax_number": "574-262-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKHOVAT-GHAHFAROKHI",
        "first_name": "SHAHIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036143877",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01090394A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125065102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300078000",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shahir.okhovat-ghahfarokhi.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1200 N East St",
            "city": "Olney",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624502432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ambrose Isikhuemen Obhade, DDS
• Occupational Health Centers of the Southwest, PA
• Norma Odar, CRNA
• Taylor Odviar
• Karen Ogden, RPH
• Michelle M Olson, LCSW
• Tamara Clare Olson, FNP
• Samsteve B Ombat
• Vivian U Onunkwo, MD
• Eli Opacich, PHARMD

• Pediatrics Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.