NPIMap

Individual provider Active NPI

Mastaneh Ahmadi-Kashani, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Everett, WA
National Provider Identifier
1275768186
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD60555360 Issued in WA
Practice address
1330 Rockefeller Ave
Ste 400
Everett, WA 98201-1684
Phone
(425) 261-4950
Fax
(425) 261-4951
NPI assigned
May 20, 2009
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD60555360 WA Primary

Addresses

Primary practice location

1330 Rockefeller Ave
Ste 400
Everett, WA 98201-1684

Mailing address

1019 S Central Ave
Glendale, CA 91204-2210
Phone (818) 244-4374

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
I20170516000263 CA Practitioner - Thoracic Surgery 2466773825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurwitz-Roberts a Medical CorporationGroup PAC ID 7315003365, 7 clinicians

Practice addresses (Care Compare)

1019 S Central Ave
Glendale, CA 91204-2210
Phone (818) 244-4374

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.58 of 100Reported as group
Quality
30
Promoting interoperability
0
Improvement activities
40
Cost
75.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hurwitz-Roberts a Medical Corporation Vascular Surgery CurrentSince Apr 1, 2017 Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients

Locations

1019 S Central Ave
Glendale, CA 91204
Phone (818) 244-4374

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 4

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1275768186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042210",
            "telephone_number": "818-244-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "STE 400",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4950",
            "fax_number": "425-261-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADI-KASHANI",
        "first_name": "MASTANEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD60555360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.