Individual provider Active NPI

Mohammad Reza Khorasani, M.D.

  • Diagnostic Radiology Physician
  • Sacramento, CA
National Provider Identifier
1922315472
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A131555 Issued in CA
Practice address
3000 Q St FL 1
Sacramento, CA 95816-7058
Phone
(916) 733-3301
Fax
(916) 281-3882
NPI assigned
Sep 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 267176 NY
Diagnostic Radiology Physician 2085R0202X A131555 CA Primary

Addresses

Primary practice location

3000 Q St FL 1
Sacramento, CA 95816-7058

Mailing address

3400 Data Dr
Physician Support Services
Rancho Cordova, CA 95670-7956

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
I20150902000086 CA Practitioner - Diagnostic Radiology 6507008810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1380 Lead Hill Blvd
Suite 100
Roseville, CA 95661-2997
Phone (916) 535-2030

155 Glasson Way
Suite L 10
Grass Valley, CA 95945-5723
Phone (530) 274-6677

1650 Creekside Dr
Folsom, CA 95630-3400
Phone (916) 983-7476

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

2528 Sister Mary Columba Dr
Red Bluff, CA 96080-4327
Phone (530) 528-6100

2580 Sister Mary Columba Dr
Suite 200
Red Bluff, CA 96080-4327
Phone (530) 528-6150

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 560-0319

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4414

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5190

6511 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 556-3300

7500 Hospital Dr
Sacramento, CA 95823-5403
Phone (916) 423-6176

Hospital & facility affiliations

  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516
  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150
  • Woodland Memorial Hospital Hospital, Woodland, CA, CCN 050127

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A131555CAMDDiagnostic Radiology Physician
267176NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jul 14, 2015 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology Past Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients
Sierra Nevada Memorial-Miners Hospital Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

18460 Roscoe Blvd
Fl 2
Northridge, CA 91325
Phone (818) 885-5480

2020 Court St
Redding, CA 96001
Phone (530) 243-1236

2380 Bechelli Ln
Redding, CA 96002
Phone (530) 226-1800

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1380 Lead Hill Blvd
Ste 100
Roseville, CA 95661
Phone (916) 535-2030

3000 Q St
Fl 1
Sacramento, CA 95816
Phone (916) 733-3301

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

Organizations & group practices 13

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.

View all 13

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": "1283558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1922315472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 Q ST FL 1",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167058",
            "telephone_number": "916-733-3301",
            "fax_number": "916-281-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORASANI",
        "first_name": "MOHAMMAD",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-04",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "267176",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A131555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.