Panteha Tavassol

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5151015258 Issued in MI

Practice address

28050 Grand River Ave
Farmington Hills, MI 48336-5919

Phone

(947) 521-8000

NPI assigned

Jun 17, 2021

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

Emergency Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ptavassol817621@direct.hfhs.org

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • French Camp, CA
  • NPI 1467863290
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD

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

• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1750959433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919",
            "telephone_number": "947-521-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919",
            "telephone_number": "947-521-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVASSOL",
        "first_name": "PANTEHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151015258",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "22265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davana Tatum
• Gabriel Tatum
• Kamron Tatum
• Andrea Taube
• Isaura Tavarez
• Cing Tawi
• Ruqaiah Tawil
• Sahar Tawil
• Zinab Tawil
• Lindsay Taxier

• Emergency Medicine Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.