NPIMap

Individual provider Active NPI

Mohammadreza Rohaninejad, MD

  • Surgery Physician
  • Los Gatos, CA
National Provider Identifier
1912139528
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A108612 Issued in CA
Practice address
14981 National Ave Ste 1
Los Gatos, CA 95032-2600
Phone
(408) 358-3111
Fax
(408) 358-3114
NPI assigned
Aug 14, 2009
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A108612 CA Primary

Addresses

Primary practice location

14981 National Ave Ste 1
Los Gatos, CA 95032-2600

Mailing address

14981 National Ave Ste 1
Los Gatos, CA 95032-2600
Phone (408) 358-3111

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
I20091221000210 CA Practitioner - General Surgery 0244370476 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M Reza Rohani MD Facs IncGroup PAC ID 6608093711, 2 clinicians

Practice addresses (Care Compare)

14981 National Ave
Suite 1
Los Gatos, CA 95032-2600
Phone (408) 358-3111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue41
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A108612CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Past Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Northern California Trauma Medical Group, Inc. Surgery Past Accepting new patients
South Bay Bariatrics Medical Corporation PC Surgery Past Accepting new patients

Locations

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mrohaninejad11409@santaclaravalley.direct-ci.net

Organizations & group practices 8

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 5

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1912139528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14981 NATIONAL AVE STE 1",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322600",
            "telephone_number": "408-358-3111",
            "fax_number": "408-358-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14981 NATIONAL AVE STE 1",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322600",
            "telephone_number": "408-358-3111",
            "fax_number": "408-358-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHANINEJAD",
        "first_name": "MOHAMMADREZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A108612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.