Individual provider Active NPI

Mohammad Mashayekh, MD

  • Student in an Organized Health Care Education/Training Program
  • Bronx, NY
National Provider Identifier
1700224656
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1276 Fulton Ave
Bronx, NY 10456-3402
Phone
(208) 353-6545
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Psychiatry Physician 2084P0800X 287297 NY

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456-3402

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (208) 353-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170515001559 NY Practitioner - Psychiatry 4183901424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 992-7669

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287297NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Mar 21, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Dec 23, 2017 Accepting new patients
Bronxcare Health System Psychiatry CurrentSince Mar 21, 2017 Accepting new patients
Montefiore Medical Center Psychiatry CurrentSince Dec 23, 2017 Accepting new patients
Bronxcare Health System Past Accepting new patients
Conifer Park, Inc Past Accepting new patients
Arms Acres Inc Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: mmashayekh844927@nychhc.direct-ci.com

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1700224656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "208-353-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "208-353-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHAYEKH",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "287297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.