Individual provider Active NPI

Madjid Keyvani, MD

  • Neurology Physician
  • Reno, NV
National Provider Identifier
1508965666
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
16879 Issued in NV
Practice address
1155 Mill St
Reno, NV 89502-1576
Phone
(775) 982-7878
Fax
(775) 982-4196
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 00025499 AL
Vascular Neurology Physician 2084V0102X 816325 CA
Hospitalist Physician 208M00000X 16879 NV
Neurology Physician 2084N0400X 16879 NV Primary

Addresses

Primary practice location

1155 Mill St
Reno, NV 89502-1576

Mailing address

1155 Mill St
Ms M-14
Reno, NV 89502-1576
Phone (775) 982-5262

Other practice location 1

7901 Frost St
San Diego, CA 92123
Phone (858) 939-3400

Other practice location 2

1100 Van Ness Ave
San Francisco, CA 94109-6978
Phone (415) 600-5760

Other identifiers 3

IdentifierTypeStateIssuer
051556664MedicaidAL
1508965666OtherCAMEDICAL
051530624OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090120000341 CA Practitioner - Neurology 7911967864 Reassigns benefits to 2 organizations
I20170411000788 NV Practitioner - Neurology 7911967864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

2929 Health Ctr Dr
San Diego, CA 92123-2762
Phone (858) 499-2600

75 Pringle Way
Suite 401
Reno, NV 89502-1476
Phone (775) 982-5000

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100
  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
  • Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328
  • Carson Valley Health Hospital, Gardnerville, NV, CCN 291306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00025499ALMDNeurology Physician
816325CAMDVascular Neurology Physician
33150AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Feb 21, 2017 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 22, 2008 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 22, 2008 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince May 31, 2009 Accepting new patients
Community Care Services LLC Neurology CurrentSince Feb 21, 2017 Accepting new patients
Community Care Services LLC Neurology Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1495 Mill St
Reno, NV 89502
Phone (775) 982-3500

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

75 Pringle Way
Ste 401
Reno, NV 89502
Phone (775) 982-2970

1155 Mill St
Ste L11
Reno, NV 89502

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

Interoperability endpoints

  • Direct secure messaging: mkeyvani22369@sharphealthcare.direct-ci.com
  • Direct secure messaging: mkeyvani115340@direct.renown.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1508965666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "address_2": "MS M-14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Frost St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92123",
            "country_code": "US",
            "telephone_number": "858-939-3400",
            "fax_number": "858-939-3466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Van Ness Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941096978",
            "country_code": "US",
            "telephone_number": "415-600-5760",
            "fax_number": "415-369-1208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYVANI",
        "first_name": "MADJID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "00025499",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "816325",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "16879",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NV",
            "license": "16879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556664",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1508965666",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "051530624",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.