Borna Mohabbatizadeh, M.D.

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

317613 Issued in NY

Practice address

1176 5TH Ave
New York, NY 10029-6503

Phone

(122) 241-3300

NPI assigned

Apr 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Surgical Oncology

Education

Virginia Commonwealth University, School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai Hospital Hospital, New York, NY, CCN 330024

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Icahn School of Medicine at Mount Sinai

  • Hematology & Oncology Physician
  • New York, NY
  • NPI 1750649612
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD

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

• Mount Sinai Hospital

  • Clinical Medical Laboratory
  • New York, NY
  • NPI 1033206362

  Hospital

  Care Compare affiliation
• Mount Sinai Hospital

  • General Acute Care Hospital
  • Long Island City, NY
  • NPI 1245248939
  Care Compare affiliation
• Mount Sinai Hospital

  • Rehabilitation Hospital
  • New York, NY
  • NPI 1669440327
  Care Compare affiliation
• Mount Sinai Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1932103413
  Care Compare affiliation
• Mount Sinai Hospital Pharmacy

  • General Acute Care Hospital
  • New York, NY
  • NPI 1225295512
  Care Compare affiliation
• Mount Sinai Hospital-Ambulance

  • Ambulance
  • New York, NY
  • NPI 1568601342

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1891228516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EAST 42ND STREET 10TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100878082",
            "telephone_number": "212-987-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "122-241-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHABBATIZADEH",
        "first_name": "BORNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "317613",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "317613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alan Mograby
• Fazlollah Fraydoon Mogtaderi, MD
• Marcia Moguel, FNP
• Stuart J Mogul, DPM
• Yasmin Mohabbat, M.D.
• Kamala Mohabeer, LMSW
• Mark Mohabir
• Nirmala Devi Mohabir
• Babak Mohajer, MD
• Mahsa Mohajery, M.D.

• Surgical Oncology Physician in New York, NY
• Providers in New York, NY by specialty
• Surgical Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.