NPIMap

Individual provider Active NPI

Telka Ghobadi, M.D.

  • Family Medicine Physician
  • Boardman, OH
National Provider Identifier
1417485079
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57030239 Issued in OH
Practice address
8423 Market St.
Suite 101
Boardman, OH 44512
Phone
(330) 729-8757
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57030239 OH Primary

Addresses

Primary practice location

8423 Market St.
Suite 101
Boardman, OH 44512

Mailing address

534 86TH Avenue
Laval, QC H7W3A9
CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200626001889 KY Practitioner - Family Practice 6002172780 Reassigns benefits to 1 organization
I20240503002449 NC Practitioner - Family Practice 6002172780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone (828) 286-5000

320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-3161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57030239OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince Jun 1, 2020 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Mar 19, 2024 Accepting new patients
Mercy Health Physicians Youngstown LLC Past Accepting new patients
Spring View Hospital LLC Past Accepting new patients

Locations

320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161

360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

Organizations & group practices 4

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1417485079",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "534 86TH AVENUE",
            "city": "LAVAL",
            "state": "QC",
            "postal_code": "H7W3A9"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MARKET ST.",
            "address_2": "SUITE 101",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-729-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOBADI",
        "first_name": "TELKA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "57030239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.