Gholam Reza Mohammadzadeh, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

G74293 Issued in CA

Practice address

77 Rolling Oaks Dr Ste 202
Thousand Oaks, CA 91361-1018

Phone

(805) 379-6717

Fax

(805) 379-6719

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, IA2 enrollments

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 2

Specialty

Thoracic Surgery

Education

Rush Medical College of Rush University, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Vna Home health agency, Bettendorf, IA, CCN 167012
• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Mercyone Genesis Dewitt Medical Center Hospital, Dewitt, IA, CCN 161313
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Gholam R Mohammadzadeh MD Inc a Medical Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Thousand Oaks, CA
  • NPI 1811320724
  Medicare reassignment NPD Authorized official
• Renaissance Asthetic Laser and Vein Institute, a Medical Corporation

  • Vascular Surgery Physician
  • Thousand Oaks, CA
  • NPI 1730258187
  Medicare reassignment NPD Authorized official
• Genesis Health System

  • Surgery Physician
  • Davenport, IA
  • NPI 1528616901

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  Medicare reassignment Care Compare group NPD
• Cardiac Surgery Associates SC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Downers Grove, IL
  • NPI 1043269160

  IA

  Medicare reassignment NPD
• Infusion4Health

  • Infusion Therapy Clinic/Center
  • Thousand Oaks, CA
  • NPI 1508262213
  Medicare reassignment
• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  NPD
• Genesis Health System

  • Family Medicine Physician
  • Moline, IL
  • NPI 1164538435
  NPD (past)
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Genesis Health System

  • Home Health Agency
  • Bettendorf, IA
  • NPI 1467404491
  Care Compare affiliation
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation
• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1699743625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ROLLING OAKS DR STE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611018",
            "telephone_number": "805-379-6717",
            "fax_number": "805-379-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROLLING OAKS DR STE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611018",
            "telephone_number": "805-379-6717",
            "fax_number": "805-379-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMADZADEH",
        "first_name": "GHOLAM",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G74293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G742930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Marie Mogadam
• Mogens U Wiese MD Inc
• Shima Mohammadi Zenouzi
• Sahar Mohammadi
• Sara Mohammadian, MD
• Mohsen Alirezai Chiropractic Corp
• Mohsen Alirezai Chiropractic Corp.
• Malica Mohsenzadeh
• Mojgan Hashemi-Mousavi DDS Dental Inc.
• Darrel Madriaga Molina, FNP-BC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.