Organization Active NPI

Ali Mokhtari, MD, Inc.

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1659403426
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35035614 Issued in OH
Legal business name
ALI MOKHTARI, MD, INC.
Practice address
3121 W Broad St
Columbus, OH 43204-1306
Phone
(614) 351-0450
Fax
(614) 351-1125
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Dr. Ali Mokhtari, M.D.
Title
President
Phone
(614) 351-0450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 35035614 OH Primary

Addresses

Primary practice location

3121 W Broad St
Columbus, OH 43204-1306

Mailing address

3121 W Broad St
Columbus, OH 43204-1306
Phone (614) 351-0450

Other identifiers 1

IdentifierTypeStateIssuer
0226197MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1659403426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041306",
            "telephone_number": "614-351-0450",
            "fax_number": "614-351-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041306",
            "telephone_number": "614-351-0450",
            "fax_number": "614-351-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI MOKHTARI, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "MOKHTARI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-351-0450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35035614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0226197",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.