Keivan Hosseinnejad

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

ME164062 Issued in FL

Practice address

330 N Clyde Morris Blvd Ste 10
Daytona Beach, FL 32114-2733

Phone

(386) 676-7175

Fax

(386) 676-7134

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Florida Health Care Plan, Inc

  • Preferred Provider Organization
  • Daytona Beach, FL
  • NPI 1558302042
  Medicare reassignment NPD
• Florida Health Care Plan, Inc

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1417516501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N CLYDE MORRIS BLVD STE 10",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-676-7175",
            "fax_number": "386-676-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N CLYDE MORRIS BLVD STE 10",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-676-7175",
            "fax_number": "386-676-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSEINNEJAD",
        "first_name": "KEIVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME164062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Alexander Horowitz, M.D.
• Stephanie Horrell, LCSW
• Brittany Horton- Duran, ARNP
• Kevin M Hosek
• Hospice of the Palm Coast Inc
• Kerri Hotlen
• Brandy Nichole House
• Deborah Ann Housley, MS
• Danielle Lauriet Howard, RN
• Jesse William Howard, PA-C

• Addiction Medicine (Internal Medicine) Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Addiction Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.