Individual provider Active NPI

Kiandokht Partovi, M.D.

  • Internal Medicine Physician
  • Montclair, CA
National Provider Identifier
1689763427
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C55287 Issued in CA
Practice address
5153 Holt Blvd Ste B1
Montclair, CA 91763-4837
Phone
(559) 691-9730
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X C55287 CA Primary

Addresses

Primary practice location

5153 Holt Blvd Ste B1
Montclair, CA 91763-4837

Mailing address

3135 E Huntington Blvd
Fresno, CA 93702
Phone (559) 691-9730

Other practice location 1

775 North Orange Street
Tustin, CA 92782
Phone (559) 691-9730

Other identifiers 2

IdentifierTypeStateIssuer
06700074MedicaidMS
1689763427OtherMSBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140929001350 CA Practitioner - Internal Medicine 4981652492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C55287CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surpreme Health Internal Medicine Current Accepting new patients
Community Health Partners Single Specialty CurrentSince Mar 1, 2022 Accepting new patients
Hospitalist Medicine Physicians of Mississippi, LLC Single Specialty Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689763427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 E HUNTINGTON BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93702",
            "telephone_number": "559-691-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 HOLT BLVD STE B1",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917634837",
            "telephone_number": "559-691-9730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 North Orange Street",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "92782",
            "country_code": "US",
            "telephone_number": "559-691-9730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARTOVI",
        "first_name": "KIANDOKHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C55287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06700074",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1689763427",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.