Individual provider Active NPI

Shayan Zoghi, DO

  • General Practice Physician
  • Fresno, CA
National Provider Identifier
1770110009
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
02007017A Issued in IN
Practice address
155 N Fresno St
Fresno, CA 93701-2302
Phone
(559) 499-6450
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 02007017A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X CA

Addresses

Primary practice location

155 N Fresno St
Fresno, CA 93701-2302

Mailing address

26 Fecamp
Newport Coast, CA 92657-1047
Phone (559) 999-0901

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240403003599 CA Practitioner - Family Practice 6204274657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Medical Group IncGroup PAC ID 8123930427, 71 clinicians

Practice addresses (Care Compare)

275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone (760) 323-8657

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02007017AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Medical Group, Inc. CurrentSince Feb 3, 2024 Accepting new patients

Locations

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

Interoperability endpoints

  • Direct secure messaging: shayan.zoghi.p2@direct.mydohc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1770110009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FECAMP",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571047",
            "telephone_number": "559-999-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOGHI",
        "first_name": "SHAYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02007017A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.