NPIMap

Individual provider Active NPI

Ali Mokhtarzadeh, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Minneapolis, MN
National Provider Identifier
1225299647
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
55387 Issued in MN
Practice address
420 Delaware St SE
MMC 493
Minneapolis, MN 55455-0341
Phone
(612) 625-4654
Fax
(612) 626-3119
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 55387 MN
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 55387 MN Primary

Addresses

Primary practice location

420 Delaware St SE
MMC 493
Minneapolis, MN 55455-0341

Mailing address

420 Delaware St SE
MMC 493
Minneapolis, MN 55455-0341
Phone (612) 625-4654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20121017000374 MN Practitioner - Ophthalmology 2860642402 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Minnesota Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55387MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Physicians CurrentSince Jul 7, 2013 Accepting new patients
Fairview Health Services CurrentSince Jun 7, 2013 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 7, 2013 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Feb 22, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Fairview Health Services CurrentSince Jun 7, 2013 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

420 Delaware St SE
#493
Minneapolis, MN 55455
Phone (612) 625-4400

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

701 25th Ave S
Ste 300
Minneapolis, MN 55454
Phone (612) 365-8350

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: amokhtarzadeh44021@fairview.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1225299647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 493",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4654",
            "fax_number": "612-626-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 493",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-4654",
            "fax_number": "612-626-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKHTARZADEH",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "55387",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "55387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.