Individual provider Active NPI

Seyed-Mojtaba Gashti, D.O.

  • Vascular Surgery Physician
  • Wellington, FL
National Provider Identifier
1649271925
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
H0062393 Issued in MD
Practice address
1447 Medical Park Blvd Ste 405
Wellington, FL 33414-3183
Phone
(561) 767-8342
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 239940 NY
Vascular Surgery Physician 2086S0129X H0062393 MD Primary
Surgery Physician 208600000X OS14009 FL
Surgery Physician 208600000X 25MB06746000 NJ

Addresses

Primary practice location

1447 Medical Park Blvd Ste 405
Wellington, FL 33414-3183

Mailing address

21966 Canadensis Cir
Boca Raton, FL 33428-3911
Phone (410) 409-4562

Other practice location 1

7556 Lake Worth Rd Ste 103
Lake Worth, FL 33467-2503
Phone (561) 894-1370

Other identifiers 2

IdentifierTypeStateIssuer
7978103MedicaidNJ
020127500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20170127001416 FL Practitioner - Vascular Surgery 6103812201 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of New England, College of Osteo Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Interventional and Diagnostic Radiology, CorpGroup PAC ID 2668882879, 2 clinicians

Practice addresses (Care Compare)

7556 Lake Worth Rd
Suite 103
Lake Worth, FL 33467-2503
Phone (561) 894-1370

Hospital & facility affiliations

  • Wellington Regional Medical Center Hospital, Wellington, FL, CCN 100275

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14009FLMDSurgery Physician
25MB06746000NJMDSurgery Physician
239940NYMDSurgery Physician
H0062393MDMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wazni, PLLC Surgery CurrentSince Aug 15, 2024 Accepting new patients
South Florida Surgical Specialists LLC Surgery CurrentSince Jan 1, 2017 Accepting new patients
Independent Multispecialty Group of Florida LLC Surgery CurrentSince Aug 16, 2022 Accepting new patients
Premier Interventional and Diagnostic Radiology Corp CurrentSince Nov 1, 2024 Accepting new patients
Colorado Medical Group, PLLC Surgery Past Accepting new patients
Surgical Specialists of New Jersey, LLC Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1900 Glades Rd
Ste 100
Boca Raton, FL 33431
Phone (561) 416-1145

3467 W Hillsboro Blvd
Ste A
Deerfield Beach, FL 33442
Phone (954) 202-0300

4205 W Atlantic Ave
Ste 102
Delray Beach, FL 33445
Phone (561) 819-2225

7556 Lake Worth Rd
Ste 103
Lake Worth, FL 33467
Phone (561) 641-4607

2290 10th Ave N
Ste 101
Lake Worth, FL 33461
Phone (561) 450-2703

4619 Little Rd
New Pt Richey, FL 34655
Phone (727) 372-9918

4215 Burns Rd
Ste 260
Palm Beach Gardens, FL 33410

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

295 NW Peacock Blvd
Port St Lucie, FL 34986

3657 Madaca Ln
Tampa, FL 33618

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

1447 Medical Park Blvd
Ste 405
Wellington, FL 33414
Phone (561) 767-8342

Organizations & group practices 7

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 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730592000000",
    "number": "1649271925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21966 CANADENSIS CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334283911",
            "telephone_number": "410-409-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 405",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143183",
            "telephone_number": "561-767-8342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7556 Lake Worth Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334672503",
            "country_code": "US",
            "telephone_number": "561-894-1370",
            "fax_number": "561-894-1372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASHTI",
        "first_name": "SEYED-MOJTABA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "239940",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "H0062393",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS14009",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB06746000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7978103",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020127500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.