Individual provider Active NPI

Mohammadreza Shervinrad, M.D

  • Anatomic Pathology & Clinical Pathology Physician
  • Mount Kisco, NY
National Provider Identifier
1598145120
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
76290 Issued in CT
Practice address
400 E Main St
Mount Kisco, NY 10549-3417
Phone
(914) 666-1200
NPI assigned
Jun 9, 2015
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 309266-01 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 309266-01 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 76290 CT Primary

Addresses

Primary practice location

400 E Main St
Mount Kisco, NY 10549-3417

Mailing address

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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
I20210812002845 NY Practitioner - Pathology 6507195898 Reassigns benefits to 2 organizations
I20240119001775 CT Practitioner - Pathology 6507195898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Stevens St
Norwalk, CT 06850-3852
Phone (203) 852-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309266-01NYMDAnatomic Pathology & Clinical Pathology Physician
309266NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Multi-Specialty CurrentSince Jan 8, 2024 Accepting new patients
Nuvance Health Medical Practice PC Multi-Specialty CurrentSince Jan 29, 2024 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

50 Hospital Hill Rd
Sharon, CT 06069
Phone (860) 364-4000

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1598145120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493417",
            "telephone_number": "914-666-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERVINRAD",
        "first_name": "MOHAMMADREZA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "309266-01",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "309266-01",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "76290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.