Khosrow Mehrany, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A87519 Issued in CA

Practice address

1729 Tully Rd Ste 9
Modesto, CA 95350-4081

Phone

(209) 338-7758

Fax

(209) 554-0311

NPI assigned

Sep 7, 2005

Reactivated

Apr 13, 2006

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 names 1

• Mark Mehrany Other name

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

George Washington University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJIFBA/Endpoint/BJIFBA
• FHIR API: https://fhir4.healow.com/fhir/r4/BJIFBA

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.

• Khosrow Mehrany M D Inc

  • MOHS-Micrographic Surgery Physician
  • Modesto, CA
  • NPI 1073721593
  Medicare reassignment NPD Authorized official
• El Camino Health Medical Network, LLC

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1164880761
  NPD (past)
• El Camino Hospital

  • General Acute Care Hospital
  • Mountain View, CA
  • NPI 1093712374
  NPD (past)
• El Camino Hospital

  • General Acute Care Hospital
  • Los Gatos, CA
  • NPI 1417199340
  NPD (past)
• Peninsula Dermatologic Surgery Inc

  • MOHS-Micrographic Surgery Physician
  • Menlo Park, CA
  • NPI 1598901340
  NPD (past)
• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1154472058
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1235123142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MARIPOSA AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950304317",
            "telephone_number": "209-338-7758",
            "fax_number": "209-554-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 TULLY RD STE 9",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504081",
            "telephone_number": "209-338-7758",
            "fax_number": "209-554-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRANY",
        "first_name": "KHOSROW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2021-06-21",
        "certification_date": "2020-12-04",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A87519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "MEHRANY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meetinder K Rai MD Inc
• Allysen Mefford
• Ronald M Megee, D.C.
• Diana Sue Mehanny
• Jaaneali Mehdi, M.D.
• Yasamin Mehrazar, DMD
• Sally Mei, PHARMD
• Samuel Meierer
• Steven Marc Meinert, DPT
• Jaime Mejia Morales

• Specialist in Modesto, CA
• Providers in Modesto, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.