Individual provider Active NPI

Ravin Agah, M.D.

  • Internal Medicine Physician
  • Mountain View, CA
National Provider Identifier
1528075017
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G79507 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-6386
Phone
(650) 934-7808
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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 G79507 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-6386

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201
Phone (650) 934-3519

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
I20041117001176 CA Practitioner - Internal MedicinePractitioner - General Practice 8729042882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Irvine, California College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agah Medical PCGroup PAC ID 9537695002, 2 clinicians

Practice addresses (Care Compare)

2495 Hospital Dr
Suite 550
Mountain View, CA 94040-4186
Phone (650) 770-2424

Hospital & facility affiliations

  • Intouch Home Care, Inc. Home health agency, Santa Clara, CA, CCN 059774
  • El Camino Health Hospital, Mountain View, CA, CCN 050308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79507CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agah Medical PC Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients

Locations

2495 Hospital Dr
Ste 550
Mountain View, CA 94040
Phone (650) 770-2424

Interoperability endpoints

  • Direct secure messaging: ragahmd12377@hisp.ehr.sutterhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Sutter Care at HomeSan Mateo, CA, CCN 051752 Hospice Contracted Managing Employee
Operational/Managerial Control
Nov 1, 2018
Nov 1, 2018

Owned or controlled facilities with NPI records 1

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

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.

Hospital & facility affiliations 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1528075017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201",
            "telephone_number": "650-934-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406386",
            "telephone_number": "650-934-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAH",
        "first_name": "RAVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G79507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.