NPIMap

Individual provider Active NPI

Hamidreza Moghaddam, M.D.

  • Internal Medicine Physician
  • North Miami, FL
National Provider Identifier
1477519122
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 91771 Issued in FL
Practice address
527 NE 124TH St
North Miami, FL 33161-5423
Phone
(305) 895-9233
Fax
(305) 895-9274
NPI assigned
Apr 21, 2006
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 91771 FL Primary

Addresses

Primary practice location

527 NE 124TH St
North Miami, FL 33161-5423

Mailing address

527 NE 124TH St
North Miami, FL 33161-5423
Phone (305) 895-9233

Other practice location 1

5200 NE 2nd Ave
Miami, FL 33137-2706
Phone (305) 762-3883

Other identifiers 1

IdentifierTypeStateIssuer
273130400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000459 FL Practitioner - Internal Medicine 5092730028 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1859 Van Buren St
Hollywood, FL 33020-5127
Phone (954) 920-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
99.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 91771FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
QMC LLC CurrentSince Jul 21, 2020 Accepting new patients
First Docs PC Internal Medicine CurrentSince Sep 23, 2024 Accepting new patients
Hamidreza Moghaddam MD PA Internal Medicine CurrentSince May 2, 2006 Accepting new patients

Locations

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

2801 NW 79th Ave
Miami, FL 33122
Phone (786) 466-1000

333 SE 2nd Ave
Ste 2000
Miami, FL 33131
Phone (201) 581-3411

4960 SW 72nd Ave
Ste 303
Miami, FL 33155
Phone (305) 591-1606

5200 NE 2nd Ave
Miami, FL 33137
Phone (305) 762-1387

1100 NW 95th St
Miami Shores, FL 33150
Phone (305) 835-6000

527 NE 124th St
North Miami, FL 33161
Phone (305) 891-0045

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

830 Lakeside Cir
Pompano Beach, FL 33060
Phone (954) 247-5801

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Miami Shores Nursing and Rehab CenterMiami, FL, CCN 105449 Skilled nursing facility Adp of the SNF Feb 13, 2025
Villa Maria Nursing CenterNorth Miami, FL, CCN 105232 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jul 16, 2025
Golden Glades Nursing & Rehabilitation CenterMiami, FL, CCN 106131 Skilled nursing facility Adp of the SNF Sep 30, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1477519122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 NE 124TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615423",
            "telephone_number": "305-895-9233",
            "fax_number": "305-895-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 NE 124TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615423",
            "telephone_number": "305-895-9233",
            "fax_number": "305-895-9274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 NE 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331372706",
            "country_code": "US",
            "telephone_number": "305-762-3883",
            "fax_number": "305-762-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "HAMIDREZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 91771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273130400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.