Individual provider Active NPI

Mohammed Fahd Qazi, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1215369418
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54660 Issued in AZ
Practice address
500 W Thomas Rd Ste 900a
Phoenix, AZ 85013-4223
Phone
(602) 406-3540
Fax
(602) 406-7186
NPI assigned
Jul 30, 2013
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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 A133659 CA
Internal Medicine Physician 207R00000X 54660 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 900a
Phoenix, AZ 85013-4223

Mailing address

3030 N Central Ave Ste 1001
Phoenix, AZ 85012-2716
Phone (602) 406-4786

Other practice location 1

2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830
Phone (714) 626-8611

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mqazi491971@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ, UT3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150721002874 CA Practitioner - Internal Medicine 8224341128 Reassigns benefits to 1 organization
I20171121001705 AZ Practitioner - Internal Medicine 8224341128
I20210126000326 UT Practitioner - Internal Medicine 8224341128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1900 Dresden Dr
Lincoln, CA 95648-8803
Phone (916) 543-5153

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133659CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group Family Medicine Current Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
University of Utah Community Physicians Group CurrentSince Jan 1, 2021 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 25, 2024 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Mar 25, 2024 Accepting new patients
University of Utah Community Physicians Group Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Livi Medical Services LLC Family Medicine PastSince Aug 26, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1900 Dresden Dr
Lincoln, CA 95648
Phone (916) 543-5153

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

Interoperability endpoints

  • Direct secure messaging: mqazi491971@direct.med.utah.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1215369418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1001",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122716",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 900A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134223",
            "telephone_number": "602-406-3540",
            "fax_number": "602-406-7186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2141 N Harbor Blvd Ste 25000",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353830",
            "country_code": "US",
            "telephone_number": "714-626-8611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QAZI",
        "first_name": "MOHAMMED",
        "middle_name": "FAHD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A133659",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "54660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mqazi491971@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.