Individual provider Active NPI

Maedeh Khayyat Kholghi, DO

  • Cardiovascular Disease Physician
  • Glendale, AZ
National Provider Identifier
1376049528
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
011221 Issued in AZ
Practice address
18700 N 64TH Dr Ste 301
Glendale, AZ 85308-7114
Phone
(602) 841-0741
NPI assigned
Apr 4, 2018
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X NM
Cardiovascular Disease Physician 207RC0000X 011221 AZ Primary

Addresses

Primary practice location

18700 N 64TH Dr Ste 301
Glendale, AZ 85308-7114

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Other practice location 1

1 University Of New Mexico
Albuquerque, NM 87131-3098
Phone (480) 570-1028

Other practice location 2

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Other names 1

  • Dr. Maedeh Kholghi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240920002283 AZ Practitioner - Cardiovascular Disease (Cardiology) 5799036083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Arizona College of Osteopathic Medicine Mid Western University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

14815 W Bell Rd
Suite 104
Surprise, AZ 85374-7603
Phone (623) 745-4762

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.38 of 100Reported as apm
Quality
80.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Outpatient Clinics, Inc. CurrentSince Sep 10, 2024 Accepting new patients
VHS Outpatient Clinics, Inc. Family Medicine CurrentSince Sep 10, 2024 Accepting new patients

Locations

21250 W Roosevelt St
Ste 306
Buckeye, AZ 85326
Phone (480) 420-0749

18700 N 64th Dr
Ste 201
Glendale, AZ 85308
Phone (602) 699-6272

18700 N 64th Dr
Ste 301
Glendale, AZ 85308
Phone (623) 561-5437

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

1325 N Litchfield Rd
Ste 130
Goodyear, AZ 85395
Phone (602) 249-8577

5130 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (602) 237-0039

708 S Coeur D Alene Ln
Ste 100
Payson, AZ 85541
Phone (928) 472-7440

26900 N Lake Pleasant Pkwy
Ste 210
Peoria, AZ 85383
Phone (623) 561-3000

14815 W Bell Rd
Ste 104
Surprise, AZ 85374
Phone (623) 266-1041

519 Rose Ln
Wickenburg, AZ 85390
Phone (844) 888-0408

Interoperability endpoints

  • Direct secure messaging: maedeh.khayyat.kholghi.1@600.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1376049528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 N 64TH DR STE 301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087114",
            "telephone_number": "602-841-0741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871313098",
            "country_code": "US",
            "telephone_number": "480-570-1028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAYYAT KHOLGHI",
        "first_name": "MAEDEH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "011221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAEDEH",
            "last_name": "KHOLGHI",
            "prefix": "DR.",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.