Individual provider Active NPI

Salina Mostajabian, M.D.

  • Pediatric Adolescent Medicine Physician
  • Austin, TX
National Provider Identifier
1467716621
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
P9915 Issued in TX
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

Updated by the provider on May 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180629001679 TX Practitioner - Pediatric Medicine 8820344096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME162310FLMDPediatric Adolescent Medicine Physician
15748FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Community Clinic Inc CurrentSince Aug 16, 2018 Accepting new patients
People'S Community Clinic, Inc. CurrentSince Aug 16, 2018 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.