Ghazal Moghaddami, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10479 Issued in AZ

Practice address

1707 W Saint Marys Rd Ste 101
Tucson, AZ 85745-2612

Phone

(520) 396-1370

Fax

(520) 396-1375

NPI assigned

May 18, 2024

Last updated

Aug 27, 2024By the provider in NPPES

Sex

Female

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 AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tucson Physician Group Holdings LLCGroup PAC ID 0547560070, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Mary's Hospital Hospital, Tucson, AZ, CCN 030010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: ghazal.moghaddami.1@600.direct.athenahealth.com

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.

• Tucson Physician Group Holdings, LLC

  dba Carondelet Medical Group

  • Interventional Cardiology Physician
  • Tucson, AZ
  • NPI 1356726939
  Medicare reassignment Care Compare group
• Carondelet Medical Group, Inc

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1659326585
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SMSJ Tucson Holdings LLC

  dba St. Marys Hospital

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265818488
  Care Compare affiliation

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1629827894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 W SAINT MARYS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W SAINT MARYS RD STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452612",
            "telephone_number": "520-396-1370",
            "fax_number": "520-396-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAMI",
        "first_name": "GHAZAL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Moffitt, PH.D.
• Gina Victor Farid Moftah
• Brianna Moga
• Christopher Tyler Mogan, C.C.P.
• Megan M Mogan, CCC-SLP
• Mahmoud Moghaddami, APRN
• Pejman Moghbeli, DMD
• Abdullah I Mohamad
• Alromesa Mohamed
• Farhan Mohamed

• Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.