Individual provider Active NPI

Pejmon Patrick Estakhri, MD

  • Colon & Rectal Surgery Physician
  • Fresno, CA
National Provider Identifier
1215460506
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
157582 Issued in CA
Practice address
6121 N Thesta St Ste 202
Fresno, CA 93710-5294
Phone
(559) 440-0283
NPI assigned
Apr 4, 2017
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 157582 CA
Colon & Rectal Surgery Physician 208C00000X 157582 CA Primary

Addresses

Primary practice location

6121 N Thesta St Ste 202
Fresno, CA 93710-5294

Mailing address

6121 N Thesta St Ste 202
Fresno, CA 93710-5294
Phone (559) 440-0283

Other names 1

  • Pej Estakhri Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241009004525 CA Practitioner - Colorectal Surgery (Proctology) 5890165260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6121 N Thesta St
Suite 202
Fresno, CA 93710-5294
Phone (559) 440-0283

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157582CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group Surgery CurrentSince Nov 1, 2024 Accepting new patients
Community Foundation Medical Group Surgery CurrentSince Nov 1, 2024 Accepting new patients
Community Foundation Medical Group Current Accepting new patients

Locations

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

6121 N Thesta St
Ste 202
Fresno, CA 93710
Phone (559) 440-0283

Interoperability endpoints

  • Direct secure messaging: pejmon.estakhri@hca9.eclinicaldirectplus.com
  • Direct secure messaging: pestakhri416352@directhoustonmethodist.org

Organizations & group practices 3

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 2

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1215460506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST STE 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105294",
            "telephone_number": "559-440-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST STE 202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105294",
            "telephone_number": "559-440-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTAKHRI",
        "first_name": "PEJMON",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "157582",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "157582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEJ",
            "last_name": "ESTAKHRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.