Individual provider Active NPI

Behrouz Darabi Farsi, PA-C

  • Physician Assistant
  • Stanford, CA
National Provider Identifier
1417971987
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15075 Issued in CA
Practice address
300 Pasteur Dr
MC 5500
Stanford, CA 94305-2200
Phone
(650) 724-7192
Fax
(650) 736-4167
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15075 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
MC 5500
Stanford, CA 94305-2200

Mailing address

3071 Payne Ave
San Jose, CA 95128-4054
Phone (408) 540-5400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000479 CA Practitioner - Physician Assistant 4981774775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15075CAMDOccupational Therapist
PA15075CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Jun 1, 2018 Accepting new patients
Bass Medical Group CurrentSince Jun 1, 2018 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

15899 Los Gatos Almaden Rd
Ste 12
Los Gatos, CA 95032
Phone (408) 358-2663

3071 Payne Ave
San Jose, CA 95128
Phone (408) 540-5400

Interoperability endpoints

  • Direct secure messaging: bfarsi120669@ehr.johnmuirhealth.com

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1417971987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 PAYNE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284054",
            "telephone_number": "408-540-5400",
            "fax_number": "408-540-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "MC 5500",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-724-7192",
            "fax_number": "650-736-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARSI",
        "first_name": "BEHROUZ",
        "middle_name": "DARABI",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.