Individual provider Active NPI

Rey Moosavi, M.D.

  • General Practice Physician
  • El Cajon, CA
National Provider Identifier
1801972716
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A35706 Issued in CA
Practice address
1333 E Main St
El Cajon, CA 92021-6540
Phone
(619) 447-6001
Fax
(619) 447-6096
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A35706 CA Primary

Addresses

Primary practice location

1333 E Main St
El Cajon, CA 92021-6540

Mailing address

1333 E Main St
El Cajon, CA 92021-6540
Phone (619) 447-6001

Other identifiers 1

IdentifierTypeStateIssuer
00A357060MedicaidCA

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
I20040316000733 CA Practitioner - General Practice 1759271653 Practice locations: El Cajon, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A35706CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fereshteh Jahanpanah a Professional Medical Corporation Past Accepting new patients
Fereshteh Jahanpanah M.D., a Professional Medical Corporation PastSince Dec 3, 2023 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1801972716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920216540",
            "telephone_number": "619-447-6001",
            "fax_number": "619-447-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 E MAIN ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920216540",
            "telephone_number": "619-447-6001",
            "fax_number": "619-447-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSAVI",
        "first_name": "REY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A35706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A357060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.