NPIMap

Individual provider Active NPI

Afsaneh Haftbaradaran Mohammadi, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
National Provider Identifier
1902040009
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A118197 Issued in CA
Practice address
11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505
Phone
(714) 241-9200
NPI assigned
Apr 21, 2009
Last updated
Feb 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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 NU
Nephrology Physician 207RN0300X A118197 CA Primary

Addresses

Primary practice location

11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505

Mailing address

11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505
Phone (714) 241-9200

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
I20170217001117 CA Practitioner - Nephrology 8325321318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1140 W la Veta Ave
Suite 400
Orange, CA 92868-4226
Phone (949) 403-5555

25411 Cabot Rd
Laguna Hills, CA 92653-5517
Phone (949) 403-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118197CAMDMarriage & Family Therapist
A118197CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Afsaneh Haftbaradaran Mohammadi MD Inc Nephrology CurrentSince May 23, 2016 Accepting new patients
Pacific Renal Care Medical Corp Nephrology CurrentSince Feb 1, 2017 Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
Mokabberi MD Inc PastSince Jun 17, 2021 Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients

Locations

11180 Warner Ave
Ste 463
Fountain Vly, CA 92708
Phone (714) 241-9200

25411 Cabot Rd
Ste 105
Laguna Hills, CA 92653
Phone (949) 403-5555

1140 W La Veta Ave
Ste 400
Orange, CA 92868
Phone (949) 403-5555

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: afsaneh.haftbaradaranmohammadi.1@26937.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1902040009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFTBARADARAN MOHAMMADI",
        "first_name": "AFSANEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A118197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.