Individual provider Active NPI

Marjan Kaveh, D.C.

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1740455492
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26964 Issued in CA
Practice address
95 Montgomery Dr Ste 202
Santa Rosa, CA 95404-3202
Phone
(707) 228-8405
NPI assigned
Apr 24, 2008
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26964 CA Primary

Addresses

Primary practice location

95 Montgomery Dr Ste 202
Santa Rosa, CA 95404-3202

Mailing address

95 Montgomery Dr
Santa Rosa, CA 95404-6630
Phone (707) 228-8405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090504000168 CA Practitioner - ChiropracticPractitioner - Neurology 9133277023 Practice locations: Santa Rosa, CA
I20191015002655 FL Practitioner - Chiropractic 9133277023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7035 Beracasa Way
Suite 104
Boca Raton, FL 33433-3454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26964CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Neurology Enhancement Center CurrentSince Apr 1, 2020 Accepting new patients

Locations

95 Montgomery Dr
Ste 118
Santa Rosa, CA 95404
Phone (707) 228-8405

2900 N Military Trl
Ste 244N
Boca Raton, FL 33431
Phone (561) 367-0078

7035 Beracasa Way
Ste 104
Boca Raton, FL 33433
Phone (561) 361-4888

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1740455492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046630",
            "telephone_number": "707-228-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043202",
            "telephone_number": "707-228-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVEH",
        "first_name": "MARJAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.