Active NPI
Salina Mostajabian, M.D.
- Pediatric Adolescent Medicine Physician
- Austin, TX
National Provider Identifier
1467716621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- P9915
- Practice address
- 1101 Camino la Costa
Austin, TX 78752 - Phone
- (512) 478-4939
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 15748 | FL | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | P9915 | TX | Primary |
| Pediatric Adolescent Medicine Physician | 2080A0000X | ME162310 | FL |
Addresses
Primary practice location
1101 Camino la Costa
Austin, TX 78752
Mailing address
1101 Camino la Costa
Austin, TX 78752-3930
Phone (512) 478-4939
Other practice location 1
3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (941) 685-1346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME162310 | FL | MD | Pediatric Adolescent Medicine Physician |
| 15748 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Community Clinic Inc | Current | Accepting new patients | |
| People'S Community Clinic, Inc. | Current | Accepting new patients |
Locations
1101 Camino La Costa
Austin, TX 78752
Phone (512) 478-4939
10335 US Highway 290 E
Bldg 35
Manor, TX 78653
Phone (512) 478-4939
Interoperability endpoints
- smostajabian668573@direct.ochin.org
Organizations & group practices 2
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.
-
- Clinic/Center
- Austin, TX
- NPI 1598896391
-
- Federally Qualified Health Center (FQHC)
- Manor, TX
- NPI 1083019905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1467716621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 CAMINO LA COSTA",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787523930",
"telephone_number": "512-478-4939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 CAMINO LA COSTA",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78752",
"telephone_number": "512-478-4939"
}
],
"practiceLocations": [
{
"address_1": "3100 SW 62nd Ave",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331553009",
"country_code": "US",
"telephone_number": "941-685-1346",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSTAJABIAN",
"first_name": "SALINA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-02",
"last_updated": "2023-05-03",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "15748",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "TX",
"license": "P9915",
"primary": true
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "FL",
"license": "ME162310",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.