Kourosh Dastgheib, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A85637 Issued in CA

Practice address

12665 Garden Grove Blvd Ste 301
Garden Grove, CA 92843-1917

Phone

(909) 581-6732

Fax

(909) 581-6737

NPI assigned

Mar 24, 2006

Last updated

Dec 4, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Ophthalmology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kourosh Alexander Dastgheib, M.D., Inc

  • Ophthalmology Physician
  • Garden Grove, CA
  • NPI 1922205202
  Medicare reassignment NPD
• M Alexander Bonakdar OD Inc

  dba Eyecare center of OC

  • Ophthalmology Physician
  • Santa Ana, CA
  • NPI 1548433477
  NPD (past)
• Family Eye Group, P.C.

  • Ophthalmology Physician
  • Ephrata, PA
  • NPI 1316351679
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1578523593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "714-636-6282",
            "fax_number": "714-422-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431917",
            "telephone_number": "909-581-6732",
            "fax_number": "909-581-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASTGHEIB",
        "first_name": "KOUROSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A85637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Truc Huy Dao, MD
• Tu Catherine Dao, DDS
• Wendy Thuy Dao, PA
• Andy Darnall
• Dylan Darrow
• Dat Q Nguyen, MD, Inc
• David D Brown DO Inc
• David Donaldson Brown DO Inc
• David Lee DDS, Ms, Inc
• Benedick Franco David

• Ophthalmology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.