NPIMap

Individual provider Active NPI

Khosro Farhad, MD

  • Clinical Neurophysiology Physician
  • Dover, NH
National Provider Identifier
1609069111
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
16005 Issued in NH
Practice address
10 Members Way Ste 300
Dover, NH 03820-5933
Phone
(603) 749-0913
Fax
(603) 749-0973
NPI assigned
Aug 20, 2007
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 264422 MA
Neurology Physician 2084N0400X 16005 NH
Clinical Neurophysiology Physician 2084N0600X 16005 NH Primary

Addresses

Primary practice location

10 Members Way Ste 300
Dover, NH 03820-5933

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 749-0913

Other practice location 1

121 Corporate Drive
Suite 200
Portsmouth, NH 03801
Phone (603) 749-0913

Other identifiers 1

IdentifierTypeStateIssuer
3086460MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130823000543 NH Practitioner - Neurology 2365685393 Reassigns benefits to 1 organization
I20161117001533 MA Practitioner - Neurology 2365685393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 593-3400

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

801 Central Ave
Level1
Dover, NH 03820-2529
Phone (603) 740-9713

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16005NHMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Dec 1, 2016 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Aug 1, 2013 Accepting new patients
Wentworth Douglass Physician Corporation Neurology Current Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Neurology CurrentSince Aug 1, 2024 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Aug 1, 2013 Accepting new patients
Massachusetts General Physicians Organization Inc Neurology CurrentSince Dec 1, 2016 Accepting new patients
Westchester Neurological Consultant PC Neurology Past Accepting new patients
Seacoast Radiology, PA Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

480 Lynnfield St
Lynn, MA 01904
Phone (781) 581-3280

10 Members Way
Ste 300
Dover, NH 03820
Phone (603) 742-7222

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

801 Central Ave
Ste 1
Dover, NH 03820
Phone (603) 740-9713

121 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 610-8075

73 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 610-8050

Interoperability endpoints

  • Direct secure messaging: farhad.khosro.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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 8

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1609069111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-749-0913",
            "fax_number": "603-749-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY STE 300",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-749-0913",
            "fax_number": "603-749-0973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Corporate Drive",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "03801",
            "country_code": "US",
            "telephone_number": "603-749-0913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARHAD",
        "first_name": "KHOSRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "264422",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "16005",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NH",
            "license": "16005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086460",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.