Individual provider Active NPI

Nazira Mojadidi, MD

  • Family Medicine Physician
  • Modesto, CA
National Provider Identifier
1477180438
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A188371 Issued in CA
Practice address
1400 Florida Ave Ste 200
Modesto, CA 95350-4445
Phone
(209) 576-3528
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X A188371 CA
Family Medicine Physician 207Q00000X A188371 CA Primary

Addresses

Primary practice location

1400 Florida Ave Ste 200
Modesto, CA 95350-4445

Mailing address

1755 Mintwood Dr
Concord, CA 94521-2106
Phone (925) 464-9639

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930002392 CA Practitioner - Family PracticePractitioner - Pain Management 7012319031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pain Management
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

4820 Business Ctr Dr
Suite 220
Fairfield, CA 94534-1696
Phone (510) 278-2700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Management Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1200 Concord Ave
Ste 140
Concord, CA 94520
Phone (925) 265-8889

4820 Business Center Dr
#220
Fairfield, CA 94534

4820 Business Center Dr
Ste 220
Fairfield, CA 94534
Phone (510) 278-2700

650 University Ave
Ste 100
Sacramento, CA 95825
Phone (916) 333-5800

1144 Sonoma Ave
Ste 105
Santa Rosa, CA 95405
Phone (707) 202-5606

450 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 413-4960

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1477180438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 MINTWOOD DR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945212106",
            "telephone_number": "925-464-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FLORIDA AVE STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504445",
            "telephone_number": "209-576-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJADIDI",
        "first_name": "NAZIRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A188371",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A188371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.