Keka Amin Mostofa, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A125471 Issued in CA

Practice address

1650 Creekside Dr
Folsom, CA 95630-3400

Phone

(916) 986-4426

Fax

(916) 986-4434

NPI assigned

Jun 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  dba Mercy Medical Group, a service of Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - North State, a service of Dignity Healt

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD

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

• Dignity Health

  dba Mercy San Juan Medical Center

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  Care Compare affiliation

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1740591650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-379-2948",
            "fax_number": "916-858-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303400",
            "telephone_number": "916-986-4426",
            "fax_number": "916-986-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTOFA",
        "first_name": "KEKA",
        "middle_name": "AMIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": "186191",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A125471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Ellen Morrison, M.F.T.
• Annelise Mortensen
• Mosaic Therapy and Wellness
• Francesca Moser
• Christina Maria Moskala, D.P.T.
• Alishee S Moten
• Mitsumaro Motoyoshi, PT
• Fleuree Moua
• Holly Mounts, PT
• Mahnaz Moussavi, DDS

• Internal Medicine Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.