Individual provider Active NPI

Kiumars Ghahremani Ghadjar, M.D.

  • Anesthesiology Physician
  • San Jose, CA
National Provider Identifier
1417299595
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A133673 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5110
Fax
(408) 885-6317
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X A133673 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5110

Other names 1

  • Dr. Kiu Ghadjar Other name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829002852 CA Practitioner - Anesthesiology 3577836444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York at Buffalo School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 200-1705

25751 McBean Pkwy
Suite 105
Valencia, CA 91355-3701
Phone (661) 200-1315

26357 McBean Pkwy
Suite 100
Santa Clarita, CA 91355-4489
Phone (661) 799-8300

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-5437

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133673CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 1, 2024 Accepting new patients
Relevo Health PC Anesthesiology CurrentSince Sep 23, 2023 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 1, 2024 Accepting new patients
Relevo Health PC Anesthesiology CurrentSince Sep 23, 2023 Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Cep America - Anesthesia PC Anesthesiology Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

25751 McBean Pkwy
Ste 105
Valencia, CA 91355
Phone (661) 200-1315

25751 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-1315

26357 McBean Pkwy
Ste 100
Valencia, CA 91355
Phone (661) 799-8300

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1417299595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5110",
            "fax_number": "408-885-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5110",
            "fax_number": "408-885-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHADJAR",
        "first_name": "KIUMARS",
        "middle_name": "GHAHREMANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A133673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIU",
            "last_name": "GHADJAR",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.