Individual provider Active NPI

Homan Hajbandeh, M.D.

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1558320333
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30187 Issued in AZ
Practice address
255 S Dobson Rd Ste 1
Chandler, AZ 85224-6231
Phone
(480) 722-2595
Fax
(480) 722-2599
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30187 AZ Primary

Addresses

Primary practice location

255 S Dobson Rd Ste 1
Chandler, AZ 85224-6231

Mailing address

255 S Dobson Rd
Suite 1
Chandler, AZ 85224-6231
Phone (480) 722-2595

Other identifiers 1

IdentifierTypeStateIssuer
695166MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051213000447 AZ Practitioner - Family Practice 1850312208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Homan Hajbandeh MD PLLCGroup PAC ID 5991789463, 6 clinicians

Practice addresses (Care Compare)

255 S Dobson Rd
Suite 1
Chandler, AZ 85224-6231
Phone (480) 722-2595

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30187AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
George Roso, M.D., P.L.L.C Family Medicine Current Accepting new patients
Homan Hajbandeh, M.D., P.L.L.C Family Medicine CurrentSince Jul 1, 2002 Accepting new patients

Locations

255 S Dobson Rd
Ste 1
Chandler, AZ 85224
Phone (480) 722-2595

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 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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558320333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S DOBSON RD",
            "address_2": "SUITE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246231",
            "telephone_number": "480-722-2595",
            "fax_number": "480-722-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S DOBSON RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246231",
            "telephone_number": "480-722-2595",
            "fax_number": "480-722-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJBANDEH",
        "first_name": "HOMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "30187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "695166",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.