Individual provider Active NPI

Kiumars Ranjbar Tabar, MD

  • Surgery Physician
  • Monroeville, PA
National Provider Identifier
1467842807
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD462493 Issued in PA
Practice address
2566 Haymaker Rd Ste 311
Monroeville, PA 15146-3555
Phone
(412) 359-6800
Fax
(412) 359-4721
NPI assigned
Jan 23, 2015
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD462493 PA Primary

Addresses

Primary practice location

2566 Haymaker Rd Ste 311
Monroeville, PA 15146-3555

Mailing address

2566 Haymaker Rd Ste 311
Monroeville, PA 15146-3555
Phone (412) 359-6800

Other practice location 1

1 Gustave L. Levy Place
New York, NY 10029
Phone (212) 659-8522

Other identifiers 2

IdentifierTypeStateIssuer
103356009MedicaidPA
13621080OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktabar138517@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20171025000744 PA Practitioner - General Surgery 5193091890 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD462493PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Sep 7, 2017 Accepting new patients
Allegheny Clinic Transplant Surgery CurrentSince Sep 7, 2017 Accepting new patients

Locations

2566 Haymaker Rd
Ste 311
Monroeville, PA 15146
Phone (412) 359-6800

320 E North Ave
Fl 4
Pittsburgh, PA 15212
Phone (412) 359-3319

320 E North Ave
Ste 261
Pittsburgh, PA 15212
Phone (412) 359-3901

420 E North Ave
Ste 304
Pittsburgh, PA 15212
Phone (412) 359-4022

Interoperability endpoints

  • Direct secure messaging: ktabar138517@direct.ahn.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1467842807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2566 HAYMAKER RD STE 311",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463555",
            "telephone_number": "412-359-6800",
            "fax_number": "412-359-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2566 HAYMAKER RD STE 311",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463555",
            "telephone_number": "412-359-6800",
            "fax_number": "412-359-4721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L. Levy Place",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-659-8522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANJBAR TABAR",
        "first_name": "KIUMARS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-23",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD462493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103356009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13621080",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktabar138517@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2566 Haymaker Rd Ste 311",
            "city": "Monroeville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151463555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.