Individual provider Active NPI

Amir A Dehghan, DPM

  • Podiatrist
  • Fremont, CA
National Provider Identifier
1407938061
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3488 Issued in CA
Practice address
38143 Martha Ave
Fremont, CA 94536-3800
Phone
(510) 713-2228
Fax
(510) 574-0407
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3488 CA Primary

Addresses

Primary practice location

38143 Martha Ave
Fremont, CA 94536-3800

Mailing address

38143 Martha Ave
Fremont, CA 94536-3800
Phone (510) 713-2228

Other identifiers 1

IdentifierTypeStateIssuer
000E34881MedicaidCA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110001285 CA Practitioner - Podiatry 7315132776 Practice locations: Fremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

38143 Martha Ave
Fremont, CA 94536-3800
Phone (510) 713-2228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3488CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ebrahim Ahmadi, M D Inc. Past Accepting new patients
University Healthcare Alliance Past Accepting new patients
Washington Township Hospital District Past Accepting new patients

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1407938061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38143 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363800",
            "telephone_number": "510-713-2228",
            "fax_number": "510-574-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38143 MARTHA AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945363800",
            "telephone_number": "510-713-2228",
            "fax_number": "510-574-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHGHAN",
        "first_name": "AMIR",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E34881",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.