NPIMap

Individual provider Active NPI

Mohsen Kheradpezhouh, M.D.

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1346363405
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A99424 Issued in CA
Practice address
1344 S Apollo Blvd FL 2
Melbourne, FL 32901-3183
Phone
(321) 727-3495
NPI assigned
Apr 6, 2007
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A99424 CA Primary

Addresses

Primary practice location

1344 S Apollo Blvd FL 2
Melbourne, FL 32901-3183

Mailing address

2194 Highway A1A Ste 203
Indian Harbour Beach, FL 32937-4931

Other practice location 1

2194 Highway A1A Ste 203
Indian Harbour Beach, FL 32937-4931
Phone (833) 867-2329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080527000473 CA Practitioner - Internal MedicinePractitioner - General Practice 4082783436 Reassigns benefits to 2 organizations
I20241212001621 FL Practitioner - Internal Medicine 4082783436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Healthcare, IncGroup PAC ID 5496652380, 42 clinicians

Practice addresses (Care Compare)

1344 S Apollo Blvd
Melbourne, FL 32901-3183

1344 S Apollo Blvd
Melbourne, FL 32901-3185

6300 N Wickham Rd
Melbourne, FL 32940-2023

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Healthcare, Inc Current Accepting new patients
Omni Healthcare, Inc. Family Medicine CurrentSince Nov 25, 2024 Accepting new patients
Centinela Hospitalist Medical Group Inc Internal Medicine CurrentSince Jul 9, 2012 Accepting new patients
Mohsen Kheradpezhouh MD, Inc Internal Medicine CurrentSince Jul 15, 2014 Accepting new patients
Petrel Emergency Physicians, a Medical Corporation PastSince Sep 28, 2015 Accepting new patients
Astrana Care Hospitalists, a Medical Corporation PastSince Jan 19, 2020 Accepting new patients
North Brevard Medical Support, Inc Past Accepting new patients
California Hospitalists Emergency Physicians Medical Group Inc Past Accepting new patients
Gezel Saheli MD.Inc Past Accepting new patients

Locations

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 264-2561

1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032

6300 N Wickham Rd
Ste 132A
Melbourne, FL 32940
Phone (321) 253-4032

6300 N Wickham Rd
Ste 132B
Melbourne, FL 32940
Phone (321) 253-4032

Interoperability endpoints

  • Direct secure messaging: mohsenkheradpezhouh@ohi.allscriptsdirect.net

Organizations & group practices 9

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 5

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1346363405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2194 HIGHWAY A1A STE 203",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 S APOLLO BLVD FL 2",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013183",
            "telephone_number": "321-727-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2194 Highway A1A Ste 203",
            "address_purpose": "LOCATION",
            "city": "Indian Harbour Beach",
            "state": "FL",
            "postal_code": "329374931",
            "country_code": "US",
            "telephone_number": "833-867-2329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHERADPEZHOUH",
        "first_name": "MOHSEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A99424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.