Mustafa Mahdavy, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A93215 Issued in CA

Practice address

1117 E. Devonshire Ave. Department of Pathology
Hemet, CA 92543

Phone

(985) 789-7994

Fax

(951) 765-4829

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pathology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hemet Global Medical Center Hospital, Hemet, CA, CCN 050390
• Menifee Global Medical Center Hospital, Sun City, CA, CCN 050684
• San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mustafa Mahdavy MD Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Hemet, CA
  • NPI 1467041442
  Medicare reassignment NPD Authorized official

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

• KPC Global Medical Centers, Inc.

  dba Hemet Global Medical Center

  • General Acute Care Hospital
  • Hemet, CA
  • NPI 1114239068
  Care Compare affiliation
• KPC Global Medical Centers, Inc.

  dba Menifee Global Medical Center

  • General Acute Care Hospital
  • Sun City, CA
  • NPI 1467764308
  Care Compare affiliation
• San Gorgonio Memorial Hospital

  • General Acute Care Hospital
  • Banning, CA
  • NPI 1568469997
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932296340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E. DEVONSHIRE AVE. DEPARTMENT OF PATHOLOGY",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "985-789-7994",
            "fax_number": "951-765-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E. DEVONSHIRE AVE. DEPARTMENT OF PATHOLOGY",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "92543",
            "telephone_number": "985-789-7994",
            "fax_number": "951-765-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDAVY",
        "first_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A93215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1074730",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nayeli Macias
• Yvonne R. Mackey, PHARMD
• Sudha G Madabhushi, M.D.
• Megan Ashley Madrigal, CPHT
• Nicole Magpiongbejarano
• Mai-Ching Chien M.D.
• Gargi Maity, MD
• Charlie Brian Maizares
• Maliq Majied Muhammad
• Maloo - Chicas Professional Dental Corp (Dental Dreams Dental Practice of Maloo - Chicas)

• Anatomic Pathology & Clinical Pathology Physician in Hemet, CA
• Providers in Hemet, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.