Active NPI
Kamal K. Pourmoghadam, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Orlando, FL
National Provider Identifier
1326003690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD067818L
- Practice address
- 1222 S Orange Ave
MP 817
Orlando, FL 32806-1215 - Phone
- (407) 649-6907
- Fax
- (407) 481-2035
- NPI assigned
- Apr 19, 2006
- Last updated
- Apr 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD067818L | PA | |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD067818L | PA | Primary |
Addresses
Primary practice location
1222 S Orange Ave
MP 817
Orlando, FL 32806-1215
Mailing address
1222 S Orange Ave
MP 817
Orlando, FL 32806-1215
Phone (407) 649-6907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001759842 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD067818L | PA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Past | Accepting new patients |
Interoperability endpoints
- kpourmoghadam1073380@direct.hopkinsmedicine.org
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398297600000",
"number": "1326003690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1222 S ORANGE AVE",
"address_2": "MP 817",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061215",
"telephone_number": "407-649-6907",
"fax_number": "407-481-2035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1222 S ORANGE AVE",
"address_2": "MP 817",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061215",
"telephone_number": "407-649-6907",
"fax_number": "407-481-2035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POURMOGHADAM",
"first_name": "KAMAL",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2014-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD067818L",
"primary": false
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD067818L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001759842",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.