Individual provider Active NPI

Fraidoon Mostamand, DO

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1962433771
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A7026 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103
Phone
(619) 543-6222
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO-120 GU
Emergency Medicine Physician 207P00000X 20A7026 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103

Mailing address

File No 54826
Los Angeles, CA 90074-4826
Phone (888) 486-4340

Other identifiers 1

IdentifierTypeStateIssuer
00AX70260MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GU2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040302000704 CA Practitioner - Emergency Medicine 9234026477 Reassigns benefits to 4 organizations
I20231012002302 GU Practitioner - Emergency Medicine 9234026477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

300 Fir St
San Diego, CA 92101-2327
Phone (848) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-120GUMDEmergency Medicine Physician
20A7027CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Emergency Medicine CurrentSince Jan 29, 2017 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
UC San Diego Health Community Group CurrentSince Jan 5, 2019 Accepting new patients
Guam Memorial Hospital CurrentSince Aug 20, 2023 Accepting new patients
Regents of the University of California CurrentSince Oct 25, 2014 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Oct 25, 2014 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 1, 2024 Accepting new patients
Guam Memorial Hospital CurrentSince Aug 20, 2023 Accepting new patients
Regents of the University of California CurrentSince Jan 29, 2017 Accepting new patients
Regents of the Unviersity of California Emergency Medicine Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

751 Medical Center Ct
#1182
Chula Vista, CA 91911

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File No 54826
Los Angeles, CA 90074

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1962433771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE NO 54826",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744826",
            "telephone_number": "888-486-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-543-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAMAND",
        "first_name": "FRAIDOON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GU",
            "license": "DO-120",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A7026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX70260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.