Active NPI
Mahdi Moezzi, DO
- Student in an Organized Health Care Education/Training Program
- Las Vegas, NV
National Provider Identifier
1396429353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 6655 S. Cimarron Road
VHS Gme Office, Suite 100
Las Vegas, NV 89113 - Phone
- (586) 443-1289
- NPI assigned
- Jun 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
6655 S. Cimarron Road
VHS Gme Office, Suite 100
Las Vegas, NV 89113
Mailing address
6655 S. Cimarron Road
VHS Gme Office, Suite 100
Las Vegas, NV 89113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230907003066 | NV | Order and Referring Only - Internal Medicine | 0749644854 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Michigan State University College of Human Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
367 S Gulph Rd
King of Prussia, PA 19406-3121
5320 S Rainbow Blvd
Suite 302
Las Vegas, NV 89118-1896
6101 Blue Lagoon Dr
Suite 200
Miami, FL 33126
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1396429353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6655 S. CIMARRON ROAD",
"address_2": "VHS GME OFFICE, SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 S. CIMARRON ROAD",
"address_2": "VHS GME OFFICE, SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89113",
"telephone_number": "586-443-1289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEZZI",
"first_name": "MAHDI",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-12",
"certification_date": "2023-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.