Mojdeh Heidari, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

106074 Issued in CT

Practice address

10 Princeton St
West Hartford, CT 06110-1893

Phone

(860) 707-5392

NPI assigned

Jan 24, 2019

Last updated

Jan 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ample Urgent and Primary Care LLC

  • Primary Care Clinic/Center
  • West Hartford, CT
  • NPI 1497474191
  Medicare reassignment NPD Authorized official
• New Horizon Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Hartford, CT
  • NPI 1194632521
  NPD (past) Authorized official

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1306300397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BLOOMFIELD AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952700",
            "telephone_number": "860-707-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PRINCETON ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101893",
            "telephone_number": "860-707-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDARI",
        "first_name": "MOJDEH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "106074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "106074",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hebrew Home and Hospital, Inc
• Hebrew Home and Hospital, Inc
• Hebrew Home and Hospital, Inc
• Hebrew Home and Hospital, Inc
• Hebrew Home for Health and Rehabilitation LLC
• David Joseph Heinlein, LCSW
• Ingrid Y Helander, LMFT
• Held Counseling LLC (Held Center for Healiing)
• Ben Heller, LCSW
• Carol Lynn Helman, M.D.

• Family Medicine Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.