NPIMap

Individual provider Active NPI

Mehrdad Mark Mofid, M.D.

  • Plastic Surgery Physician
  • La Jolla, CA
National Provider Identifier
1225244155
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A83432 Issued in CA
Practice address
4150 Regents Park Row
Suite 300
La Jolla, CA 92037-9124
Phone
(858) 909-9000
Fax
(858) 909-9009
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A83432 CA Primary

Addresses

Primary practice location

4150 Regents Park Row
Suite 300
La Jolla, CA 92037-9124

Mailing address

4150 Regents Park Row
Suite 300
La Jolla, CA 92037-9124
Phone (858) 909-9000

Other identifiers 1

IdentifierTypeStateIssuer
00A834320MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000611 CA Practitioner - Plastic and Reconstructive Surgery 6204726029 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Johns Hopkins University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Allies Clinic IncGroup PAC ID 8527458389, 16 clinicians

Practice addresses (Care Compare)

4150 Regents Park Row
Suite 300
La Jolla, CA 92037-1417
Phone (858) 909-9000

5395 Ruffin Rd
Suite 102
San Diego, CA 92123-1338
Phone (858) 598-5291

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83432CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Allies Clinic Inc Plastic Surgery CurrentSince Dec 9, 2021 Accepting new patients
M Mark Mofid M D a Professional Plastic Surgery CurrentSince Jan 1, 2004 Accepting new patients
Scripps Health Current Accepting new patients
San Diego Skin, Inc. CurrentSince Dec 2, 2009 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Feb 26, 2020 Accepting new patients
Palomar Health Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

4150 Regents Park Row
Ste 300
La Jolla, CA 92037
Phone (858) 909-9000

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

5395 Ruffin Rd
Ste 102
San Diego, CA 92123
Phone (858) 569-8959

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mmofid42890@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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 3

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1225244155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW",
            "address_2": "SUITE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379124",
            "telephone_number": "858-909-9000",
            "fax_number": "858-909-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW",
            "address_2": "SUITE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379124",
            "telephone_number": "858-909-9000",
            "fax_number": "858-909-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFID",
        "first_name": "MEHRDAD",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A83432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A834320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.