Mo Tavakkoli, MD, MPH, MSC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

287439 Issued in NY

Practice address

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157

Phone

(845) 680-5713

NPI assigned

Jun 27, 2013

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 1

Other names 1

• Dr. Mohammad Tavakkoli Former name

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

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.

• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392
  Medicare reassignment NPD
• Westchester Medical Center Advanced Physician Services PC

  • Anesthesiology Physician
  • Valhalla, NY
  • NPI 1740687458
  NPD
• Nys Office of Mental Health

  • Psychiatric Hospital
  • Orangeburg, NY
  • NPI 1386708550
  NPD (past)

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1215377700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARBOR SQ APT 632",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624535",
            "telephone_number": "917-943-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-680-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKKOLI",
        "first_name": "MO",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "287439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "287439",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMAD",
            "last_name": "TAVAKKOLI",
            "prefix": "DR.",
            "credential": "MD, MPH, MSC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jong Chill Sun, M.D.
• Sundala on the Farm Inc.
• Shannon Sweetman
• Josephine P. Taguibao
• Anne Marie Clare Tarangelo, DMD
• Carmel Taylor
• Arlene Gadia Tayo, BSN
• Elena Marie Temple
• Abraham Thengampallil, M.D.
• Jacob Thengampallil

• Psychiatry Physician in Orangeburg, NY
• Providers in Orangeburg, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.