Individual provider Active NPI

Amirkasra Mojtahed

  • Diagnostic Radiology Physician
  • Albuquerque, NM
National Provider Identifier
1346530409
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
RS2011-0298 Issued in NM
Practice address
4352 Altura Mesa LN NE
Albuquerque, NM 87110-5059
Phone
(505) 232-8061
NPI assigned
Apr 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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
Diagnostic Radiology Physician 2085R0202X RS2011-0298 NM Primary

Addresses

Primary practice location

4352 Altura Mesa LN NE
Albuquerque, NM 87110-5059

Mailing address

4352 Altura Mesa LN NE
Albuquerque, NM 87110-5059
Phone (505) 232-8061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20160622000426 MA Practitioner - Diagnostic Radiology 7911298963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of New Mexico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

Boston, MA 02116-5518
Phone (617) 643-0003

335 Revolution Dr
Somerville, MA 02145-1553
Phone (857) 282-7750

440 Foley St
Somerville, MA 02145-1213
Phone (857) 282-0777

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

80 Everett Ave
Chelsea, MA 02150-2339
Phone (617) 887-3500

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Martha'S Vineyard Hospital Inc Hospital, Oak Bluffs, MA, CCN 221300
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RS2011-0298NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2016 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: mojtahed.amirkasra.mgh@direct.partners.masshiway.net

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 and National Provider Directory roles.

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1346530409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4352 ALTURA MESA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105059",
            "telephone_number": "505-232-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 ALTURA MESA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105059",
            "telephone_number": "505-232-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJTAHED",
        "first_name": "AMIRKASRA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "RS2011-0298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.