NPIMap

Individual provider Active NPI

Amir Dastgah, DPM

  • Foot & Ankle Surgery Podiatrist
  • Morgan Hill, CA
National Provider Identifier
1770712101
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4988 Issued in CA
Practice address
16275 Monterey Rd Ste E
Morgan Hill, CA 95037-5466
Phone
(408) 234-6969
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

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
Foot & Ankle Surgery Podiatrist 213ES0103X E4988 CA Primary

Addresses

Primary practice location

16275 Monterey Rd Ste E
Morgan Hill, CA 95037-5466

Mailing address

16275 Monterey Rd Ste E
Morgan Hill, CA 95037-5466
Phone (408) 612-4752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000183 CA Practitioner - Podiatry 0042469884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Foot and Ankle Centers IncGroup PAC ID 0941509491, 3 clinicians

Practice addresses (Care Compare)

39210 State St
Fremont, CA 94538-1456
Phone (510) 794-6633

Hospital & facility affiliations

  • El Camino Health Hospital, Mountain View, CA, CCN 050308
  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145
  • Washington Hospital Hospital, Fremont, CA, CCN 050195
  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue24
Removal of skin lesions1-10
Removal of nail tissue516
Removal or shaving of skin growth234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4988CAMDFoot & Ankle Surgery Podiatrist
4988CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Foot and Ankle Centers Inc Foot & Ankle Surgery CurrentSince Mar 5, 2016 Accepting new patients
El Camino Hospital Past Accepting new patients
Upmc Washington Past Accepting new patients

Locations

1800 Mowry Ave
Fremont, CA 94538
Phone (510) 794-6633

39210 State St
Ste 107
Fremont, CA 94538
Phone (510) 794-6633

3775 Beacon Ave
Ste 120
Fremont, CA 94538
Phone (510) 794-6633

5 Harris Ct
Bldg C
Monterey, CA 93940
Phone (408) 868-1188

880 Cass St
Ste 103
Monterey, CA 93940
Phone (831) 375-5634

16360 Monterey St
Ste 270
Morgan Hill, CA 95037
Phone (408) 300-9787

16275 Monterey Rd
Ste E
Morgan Hill, CA 95037
Phone (408) 612-4752

200 Jose Figueres Ave
Ste 275
San Jose, CA 95116
Phone (510) 673-4077

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22059/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 7

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1770712101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16275 MONTEREY RD STE E",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950375466",
            "telephone_number": "408-612-4752",
            "fax_number": "408-612-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16275 MONTEREY RD STE E",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950375466",
            "telephone_number": "408-234-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASTGAH",
        "first_name": "AMIR",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan Hill, CA

Sources for this page

Verify at the official NPI Registry.