Individual provider Active NPI

Afshin Y Doust, M.D.

  • Internal Medicine Physician
  • Mission Viejo, CA
National Provider Identifier
1417057316
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11054 Issued in NV
Practice address
26732 Crown Valley Pkwy Ste 411
Mission Viejo, CA 92691-6375
Phone
(949) 282-1671
Fax
(949) 367-0518
NPI assigned
Sep 22, 2006
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 134958 CA
Internal Medicine Physician 207R00000X 11054 NV Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy Ste 411
Mission Viejo, CA 92691-6375

Mailing address

PO Box 370969
Las Vegas, NV 89137-0969
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
100504913MedicaidNV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adoust1374115@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041018000502 NV Practitioner - Internal Medicine 6901866532 Reassigns benefits to 2 organizations
I20170316002237 CA Practitioner - Internal Medicine 6901866532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

3100 N Tenaya Way
Las Vegas, NV 89728-0436
Phone (702) 255-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
134958CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospero Health Partners, P.C. CurrentSince Aug 1, 2021 Accepting new patients
Afshin Y Doust MD a Professional Corporation Internal Medicine CurrentSince Apr 30, 2003 Accepting new patients
Providence Medical Foundation CurrentSince Apr 28, 2017 Accepting new patients
Prospero Health Partners, P.C. CurrentSince Aug 1, 2021 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients
United Hospitalist Inc. Internal Medicine Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26800 Crown Valley Pkwy
Ste 290
Mission Viejo, CA 92691
Phone (949) 365-2444

26800 Crown Valley Pkwy
Ste 305
Mission Viejo, CA 92691
Phone (949) 360-6000

3100 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 225-5025

2020 Wellness Way
Ste 202
Las Vegas, NV 89106
Phone (702) 207-6611

200 S Virginia St
Fl 8
Reno, NV 89501
Phone (530) 536-6690

40 S Main St
Ste 1300
Memphis, TN 38103
Phone (256) 263-7354

Interoperability endpoints

  • Direct secure messaging: ms_adoust@landmarkhealth-direct.org
  • Direct secure messaging: ms_adoust1@landmarkhealth-direct.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1417057316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370969",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370969",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 411",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916375",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUST",
        "first_name": "AFSHIN",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "134958",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504913",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adoust1374115@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy Ste 305",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926918017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.