Billur Moghaddam, M.D.

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

A89124 Issued in CA

Practice address

2825 50TH St
Sacramento, CA 95817-2310

Phone

(916) 703-0413

Fax

(916) 703-0417

NPI assigned

Jun 20, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  CA

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1326209461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "916-784-4000",
            "fax_number": "877-738-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172310",
            "telephone_number": "916-703-0413",
            "fax_number": "916-703-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "BILLUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-12-22",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "A89124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1600 Eureka Rd",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956613027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessie Lynn Moeller
• Farnoush M Moen, M.D.
• Bianca Mogannam
• John Mogannam
• Azita Moghaddam, DDS
• Orkideh Pajand Moghaddam, PHARM.D.
• Mehdi Moghaddas, M.D.
• Ariana Moghbel
• Sonya Mogilner
• Mohali Inc.

• Clinical Genetics (M.D.) Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Clinical Genetics (M.D.) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.