Individual provider Active NPI

Ayda Dashtaei, D.O.

  • Surgery Physician
  • Poway, CA
National Provider Identifier
1497146120
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20A18093 Issued in CA
Practice address
15611 Pomerado Rd Ste 400
Poway, CA 92064-2437
Phone
(760) 300-3647
Fax
(858) 207-0034
NPI assigned
Feb 17, 2015
Last updated
Jun 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Surgery Physician 208600000X 20A18093 CA Primary

Addresses

Primary practice location

15611 Pomerado Rd Ste 400
Poway, CA 92064-2437

Mailing address

3048 Starry Night Dr
Escondido, CA 92029-4841
Phone (858) 207-8569

Other practice location 1

18310 US Highway 18
Apple Valley, CA 92307-2206
Phone (760) 247-6444

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
I20200707003407 CA Practitioner - General Surgery 4587974274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arch Health Partners IncGroup PAC ID 9931239027, 141 clinicians

Practice addresses (Care Compare)

15611 Pomerado Rd
Poway, CA 92064-2437
Phone (858) 675-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18093CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jul 1, 2020 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 1, 2020 Accepting new patients
Arch Health Partners, Inc Surgery CurrentSince Apr 1, 2023 Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

15611 Pomerado Rd
Ste 107
Poway, CA 92064

15611 Pomerado Rd
Ste 400
Poway, CA 92064
Phone (858) 613-8900

120 Craven Rd
Ste 201
San Marcos, CA 92078

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: adashtaei1374412@oc.providencedirect.org
  • Direct secure messaging: ayda.dashtaei.p1@direct.arch.nextgenshare.com

Organizations & group practices 6

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 2

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": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1497146120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 STARRY NIGHT DR",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294841",
            "telephone_number": "858-207-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD STE 400",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "760-300-3647",
            "fax_number": "858-207-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18310 US Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072206",
            "country_code": "US",
            "telephone_number": "760-247-6444",
            "fax_number": "760-247-6559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASHTAEI",
        "first_name": "AYDA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A18093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.