Golshan Fahimi, MD

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

A175507 Issued in CA

Practice address

23512 Madero Rd.
Mission Viejo, CA 92691

Phone

(949) 583-1600

Fax

(949) 454-8067

NPI assigned

Jul 19, 2017

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

Specialty

Neurology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gfahimi859051@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350
  Medicare reassignment Care Compare group NPD
• Beaver Medical Group P C

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment NPD
• Centers for Family Medicine GP

  • Family Medicine Physician
  • Los Alamitos, CA
  • NPI 1467598243
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Pinnacle Medical Group, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1376876912
  Medicare reassignment NPD
• Saddleback Medical Group Inc

  • Gastroenterology Physician
  • Laguna Hills, CA
  • NPI 1386605822
  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Cassidy Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • Vista, CA
  • NPI 1215003470
  NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Pinnacle Medical Group, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1043255763
  NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760
  NPD (past)
• Sutter Bay Hospitals

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1376066548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23512 MADERO RD.",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-583-1600",
            "fax_number": "949-454-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23512 MADERO RD.",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-583-1600",
            "fax_number": "949-454-8067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-4243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHIMI",
        "first_name": "GOLSHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A175507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Javad Faith, D.C
• Madeleine Kate Fajilan, PA-C
• Laurence Michael Fakinos, M.D.

• Clinical Neurophysiology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Clinical Neurophysiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.