Individual provider Active NPI

Jahangir Sadeghi, M.D.

  • Ophthalmology Physician
  • San Rafael, CA
National Provider Identifier
1689782245
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C50518 Issued in CA
Practice address
950 Northgate Dr
San Rafael, CA 94903-3433
Phone
(415) 479-2372
Fax
(415) 472-6225
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 483-265146 CA
Ophthalmology Physician 207W00000X C50518 CA Primary

Addresses

Primary practice location

950 Northgate Dr
San Rafael, CA 94903-3433

Mailing address

950 Northgate Dr
Suite 209
San Rafael, CA 94903-3414
Phone (415) 479-2372

Other identifiers 2

IdentifierTypeStateIssuer
483265146OtherCASTATE ID
C50518OtherCAMEDICAL LICENSE NUMBER

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
I20040210000555 CA Practitioner - Ophthalmology 8224922380 Reassigns benefits to 1 organization
Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louis Yang MDGroup PAC ID 0244620045, 2 clinicians

Practice addresses (Care Compare)

950 Northgate Dr
Suite 209
San Rafael, CA 94903-3433
Phone (415) 479-2372

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
483-265146CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louis Yang MD Ophthalmology CurrentSince Jan 8, 2022 Accepting new patients
Robert R. Anderson M.D., Inc. Ophthalmology Past Accepting new patients

Locations

950 Northgate Dr
Ste 209
San Rafael, CA 94903
Phone (415) 461-5500

Interoperability endpoints

  • Direct secure messaging: jahangir.sadeghi.1@14789.direct.athenahealth.com

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689782245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 NORTHGATE DR",
            "address_2": "SUITE 209",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033414",
            "telephone_number": "415-479-2372",
            "fax_number": "415-472-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033433",
            "telephone_number": "415-479-2372",
            "fax_number": "415-472-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADEGHI",
        "first_name": "JAHANGIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-03-07",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "483-265146",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C50518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "483265146",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "C50518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.