Mohammad Mertaban, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A159314 Issued in CA

Practice address

304 Sugar Tree LN
South Burlington, VT 05403-6778

Phone

(310) 351-2732

NPI assigned

Mar 25, 2017

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmertaban155323@santaclaravalley.direct-ci.net

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.

• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500

  Pediatrics

  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1629301346
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment NPD
• UCSF Pediatrics Associates

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1376614016
  Medicare reassignment NPD
• University of California San Francisco

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1043354020
  NPD
• County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1376538991
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• UCSF Medical Group Business Services

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1164512851

  Pediatrics

  NPD
• University of California San Francisco

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1427589902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SUGAR TREE LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036778",
            "telephone_number": "310-351-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SUGAR TREE LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036778",
            "telephone_number": "310-351-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTABAN",
        "first_name": "MOHAMMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-25",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A159314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William M. Mercia, MD
• Henry Mercier
• Nicholas Mercier
• Stephen John Merena, DPM
• Meridyth Sanders Massage and Bodywork
• Corrine Mertz, LICSW
• MH Health Care Services, PC
• MH Health Care Services, PC
• MH Manor South Operating, LLC
• Janet Thomason Miccolo, D.D.S.

• Pediatrics Physician in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Pediatrics Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.