Individual provider Active NPI

Farhad Sabet Mahjouri, MD, MPH

  • Addiction Medicine (Internal Medicine) Physician
  • Fresno, CA
National Provider Identifier
1497902993
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
C41863 Issued in CA
Practice address
539 N Van Ness Ave
Fresno, CA 93728-3419
Phone
(559) 266-9581
NPI assigned
Aug 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C 41863 CA
Addiction Medicine (Internal Medicine) Physician 207RA0401X C41863 CA Primary

Addresses

Primary practice location

539 N Van Ness Ave
Fresno, CA 93728-3419

Mailing address

PO Box 3793
Clovis, CA 93613-3793
Phone (559) 260-7559

Other practice location 1

1235 E St
Fresno, CA 93706-2024
Phone (559) 268-6261

Other practice location 2

3103 E Cartwright Ave
Fresno, CA 93725-9385
Phone (559) 498-7100

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
I20091125000502 CA Practitioner - Neurosurgery 0749329019 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C 41863CAMDSpecialist
C41863CAMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baart Community Healthcare CurrentSince Apr 22, 2019 Accepting new patients

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1497902993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3793",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936133793",
            "telephone_number": "559-260-7559",
            "fax_number": "559-765-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283419",
            "telephone_number": "559-266-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 E St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937062024",
            "country_code": "US",
            "telephone_number": "559-268-6261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3103 E Cartwright Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937259385",
            "country_code": "US",
            "telephone_number": "559-498-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHJOURI",
        "first_name": "FARHAD",
        "middle_name": "SABET",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C 41863",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "C41863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.