NPIMap

Individual provider Active NPI

Khashayar Montazeri, M.D.

  • Internal Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1780798702
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A77713 Issued in CA
Practice address
1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Phone
(925) 947-3393
Fax
(925) 947-3396
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A77713 CA Primary

Addresses

Primary practice location

1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501

Mailing address

PO Box 9017
Walnut Creek, CA 94598-0917
Phone (925) 952-2828

Other identifiers 2

IdentifierTypeStateIssuer
P00938334OtherCARAILROAD MEDICARE
00A777130MedicaidCA

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
I20031103000512 CA Practitioner - Internal Medicine 2365354800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2700 Grant St
Suite 200
Concord, CA 94520-2270
Phone (925) 674-0500

Hospital & facility affiliations

  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
  • San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689

Merit-based Incentive Payment System (MIPS)

Final score
83.63 of 100Reported as group
Quality
67.56
Improvement activities
40
Cost
71.56

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service CurrentSince Apr 3, 2017 Accepting new patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
East Bay Hospitalists, a Medical Corporation PastSince Jun 22, 2010 Accepting new patients
Tassajara Valley Medical Group PC Internal Medicine Past Accepting new patients
John Muir Health Past Accepting new patients
Pleasanton Optometry, Inc. PastSince Oct 12, 2001 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine Past Accepting new patients
John Muir Health Past Accepting new patients
Sutter Bay Medical Foundation Past Accepting new patients
Orohealth Corporation a Non Profit Healthcare System Internal Medicine PastSince Feb 25, 2012 Accepting new patients
Samaritan Emergency Corp Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients

Locations

2540 East St
Concord, CA 94520
Phone (925) 674-2228

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: kmontazeri9959@ehr.johnmuirhealth.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1780798702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9017",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945980917",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952501",
            "telephone_number": "925-947-3393",
            "fax_number": "925-947-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAZERI",
        "first_name": "KHASHAYAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00938334",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A777130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.