Active NPI
Hamed Rezaishiraz, MD PHD
- Psychiatry Physician
- Modesto, CA
National Provider Identifier
1437317898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A114718
- Practice address
- 1501 Claus Rd
Modesto, CA 95355-9711 - Phone
- (209) 557-6300
- NPI assigned
- Jun 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A114718 | CA | Primary |
Addresses
Primary practice location
1501 Claus Rd
Modesto, CA 95355-9711
Mailing address
1501 Claus Rd
Modesto, CA 95355-9711
Phone (716) 418-2042
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120614000647 | CA | Practitioner - Psychiatry | 2163686536 | Practice locations: Modesto, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A114718 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1437317898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 CLAUS RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559711",
"telephone_number": "716-418-2042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 CLAUS RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559711",
"telephone_number": "209-557-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZAISHIRAZ",
"first_name": "HAMED",
"name_prefix": "Dr.",
"credential": "MD PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-01",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A114718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.