NPIMap

Individual provider Active NPI

Barzan Mohedin, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • La Mesa, CA
National Provider Identifier
1639235096
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A50839 Issued in CA
Practice address
8860 Center Dr Ste 310
La Mesa, CA 91942-7001
Phone
(619) 668-9596
Fax
(619) 667-0267
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A50839 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A50839 CA Primary

Addresses

Primary practice location

8860 Center Dr Ste 310
La Mesa, CA 91942-7001

Mailing address

8860 Center Dr Ste 310
La Mesa, CA 91942-7001
Phone (619) 668-9596

Other identifiers 1

IdentifierTypeStateIssuer
00A508390MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100603000359 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5496818627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8860 Ctr Dr
Suite 310
La Mesa, CA 91942-7001
Phone (619) 668-9596

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50839CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barzan Mohedin, MD, a Professional Corporation Internal Medicine CurrentSince Feb 28, 2010 Accepting new patients
San Diego Critical Care Medical Group, Inc Internal Medicine CurrentSince Nov 24, 1998 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 25, 2014 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

8860 Center Dr
Ste 310
La Mesa, CA 91942
Phone (619) 460-4000

8851 Center Dr
Ste 305
La Mesa, CA 91942
Phone (619) 442-0234

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Interoperability endpoints

  • Direct secure messaging: bmohedin32271@sharphealthcare.direct-ci.com

Organizations & group practices 4

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 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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1639235096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8860 CENTER DR STE 310",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427001",
            "telephone_number": "619-668-9596",
            "fax_number": "619-667-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8860 CENTER DR STE 310",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427001",
            "telephone_number": "619-668-9596",
            "fax_number": "619-667-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHEDIN",
        "first_name": "BARZAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50839",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A50839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A508390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.