Individual provider Active NPI

Mahyar Mostafavi, DO

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1972398006
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(602) 943-2381
NPI assigned
Apr 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

2541 Halle Pkwy
Collierville, TN 38017-0828
Phone (901) 647-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250703001109 AZ Order and Referring Only - General SurgeryPractitioner - General Surgery 8123531985

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1972398006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 HALLE PKWY",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170828",
            "telephone_number": "901-647-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "602-943-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAFAVI",
        "first_name": "MAHYAR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.