Mohammed Mortazavi, MD

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

49421 Issued in AZ

Practice address

5199 E Farness Dr Ste 101
Tucson, AZ 85712

Phone

(520) 222-8076

Fax

(520) 300-7156

NPI assigned

Aug 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Pediatric Medicine

Education

University of California, Davis School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sparcc Professional CorporationGroup PAC ID 8820515539, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tucson Medical Center Hospital, Tucson, AZ, CCN 030006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mo.mortazavi@43033389170692.direct.elationemr.com

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.

• Sparcc Professional Corporation

  • Sports Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1003275413

  Pediatrics

  Medicare reassignment Care Compare group NPD Authorized official
• Northwest Allied Physicians LLC

  • General Practice Physician
  • Tucson, AZ
  • NPI 1003833179
  Medicare reassignment NPD
• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• Northwest Allied Physicians, LLC

  • Durable Medical Equipment & Medical Supplies
  • Oro Valley, AZ
  • NPI 1821302910
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1679703441
  NPD

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

• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Care Compare affiliation

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1871740241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 E FARNESS DR STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122262",
            "telephone_number": "520-222-8076",
            "fax_number": "520-300-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 E FARNESS DR STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-222-8076",
            "fax_number": "520-300-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTAZAVI",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-27",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "AZ",
            "license": "49421",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "49421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "923231",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1871740241",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janaiah Morsay, RBT
• Alex Morse, PT., DPT
• Karen Michelle Morse, MA
• Lynn M Morski, M.D.
• Kayvaan M Mortazavi, MD
• Zachary Van Mortensen, MD
• Duane Scott Mortenson, P.A.
• Kevin M Mortenson, D.M.D.
• Vanessa Morton, PT, DPT
• Veronica Morvay, DNP CRNA

• Pediatric Sports Medicine Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pediatric Sports Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.