Individual provider Active NPI

Bahram Taghavi, M.D.

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1407058290
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
10954 Issued in HI
Practice address
444 N 44TH St
#400
Phoenix, AZ 85008-7624
Phone
(602) 685-3846
Fax
(602) 685-3808
NPI assigned
Jun 4, 2007
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10954 HI Primary
Psychiatry Physician 2084P0800X 31730 AZ

Addresses

Primary practice location

444 N 44TH St
#400
Phoenix, AZ 85008-7624

Mailing address

444 N 44TH St
#400
Phoenix, AZ 85008-7624
Phone (602) 685-3846

Other identifiers 1

IdentifierTypeStateIssuer
941113MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20140905000719 HI Practitioner - Psychiatry 0648206169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Southern California Keck School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aloha House, Inc.Group PAC ID 8426948316, 15 clinicians

Practice addresses (Care Compare)

135 S Wakea Ave
Suite 201
Kahului, HI 96732-1385
Phone (808) 249-2121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31730AZMDPsychiatry Physician
10954HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aloha House, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients
Lafrontera Center Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients

Locations

135 S Wakea Ave
Ste 201
Kahului, HI 96732
Phone (808) 242-1660

1787 Wili Pa Loop
Ste 7
Wailuku, HI 96793
Phone (808) 249-2121

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1407058290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N 44TH ST",
            "address_2": "#400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087624",
            "telephone_number": "602-685-3846",
            "fax_number": "602-685-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N 44TH ST",
            "address_2": "#400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087624",
            "telephone_number": "602-685-3846",
            "fax_number": "602-685-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGHAVI",
        "first_name": "BAHRAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "10954",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "31730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941113",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.