Active NPI
Kaveh Mashkouri, PA-C
- Physician Assistant
- Mission Viejo, CA
National Provider Identifier
1518507987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA58073
- Practice address
- 27700 Medical Center Rd
Mission Viejo, CA 92691-6426 - Phone
- (949) 364-1400
- NPI assigned
- Jan 13, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA58073 | CA | Primary |
Addresses
Primary practice location
27700 Medical Center Rd
Mission Viejo, CA 92691-6426
Mailing address
27700 Medical Center Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA58073 | CA | MD | Physician Assistant |
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1376305755
-
- Geriatric Medicine (Family Medicine) Physician
- Long Beach, CA
- NPI 1033164017
-
- Emergency Medicine Physician
- Mission Viejo, CA
- NPI 1073542916
-
- Emergency Medicine Physician
- Laguna Beach, CA
- NPI 1134355597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1518507987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27700 MEDICAL CENTER RD",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916426",
"telephone_number": "949-364-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27700 MEDICAL CENTER RD",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916426",
"telephone_number": "949-364-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHKOURI",
"first_name": "KAVEH",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-01-13",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA58073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
- Jackelin Liseth Martinez
- Lauren Krista Martinez
- Marvin D Posner M D and Vivien L Pan M D a Medical Corporation (Perinatal Associates of Orange County)
- Mary Jean Oconnor Registered Nursing Family Nurse Practitioner
- Maryam Ekhtiar DDS Inc (Kord Dentistry)
- Shalita Masih-Antebi, O.D.
- Alyssa Mone'T Mason-Martindelcampo, ACSW
- Sedigheh E Masoum, DDS
- Becca Massip
- Patricia S Masters, LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.