Individual provider Active NPI

Matthew Mehrdad Moshirfar, DPM

  • Podiatrist
  • Sarasota, FL
National Provider Identifier
1386749877
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO002267 Issued in FL
Practice address
2190 Gulf Gate Drive
Sarasota, FL 34231
Phone
(941) 921-5521
Fax
(941) 927-0609
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO002267 FL Primary

Addresses

Primary practice location

2190 Gulf Gate Drive
Sarasota, FL 34231

Mailing address

2190 Gulf Gate Drive
Sarasota, FL 34231
Phone (941) 921-5521

Other identifiers 2

IdentifierTypeStateIssuer
390051700MedicaidFL
480015052OtherFLMEDICARE RAIL ROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000147 FL Practitioner - Podiatry 3476720558 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO002267FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mathew Mehrdad Moshirfar DPM PA CurrentSince Oct 20, 2011 Accepting new patients

Locations

2190 Gulf Gate Dr
Sarasota, FL 34231
Phone (941) 921-5521

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1386749877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 GULF GATE DRIVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34231",
            "telephone_number": "941-921-5521",
            "fax_number": "941-927-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 GULF GATE DRIVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34231",
            "telephone_number": "941-921-5521",
            "fax_number": "941-927-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHIRFAR",
        "first_name": "MATTHEW",
        "middle_name": "MEHRDAD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO002267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390051700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "480015052",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.