Mohamadreza Moghadam

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

309233 Issued in CA

Practice address

2777 Bristol St Ste B
Costa Mesa, CA 92626-5997

Phone

(949) 250-1112

NPI assigned

Nov 17, 2025

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prosport Physical Therapy Professionals IncGroup PAC ID 0749510634, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Prosport Physical Therapy Professionals Inc

  • Physical Therapy Clinic/Center
  • Costa Mesa, CA
  • NPI 1073170437
  Medicare reassignment Care Compare group
• Prosport Physical Therapy Professionals Inc

  • Specialist
  • Rancho Santa Margarita, CA
  • NPI 1487616546
  NPD
• Prosport Physical Therapy Professionals Inc

  • Physical Therapist
  • Rancho Palos Verdes, CA
  • NPI 1487648341
  NPD

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1972463495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 BRISTOL ST STE B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265997",
            "telephone_number": "949-250-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 BRISTOL ST STE B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265997",
            "telephone_number": "949-250-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADAM",
        "first_name": "MOHAMADREZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "309233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modus Acupuncture
• Rakhee Porecha Mody, DMD
• Aung Kaung Moe
• Sepideh Moeinolmolki, D.D.S.
• Lily E. Mogartoff, LCSW
• Jealan N Mohamed
• Ruweyda Mohamud
• Ronny Mohtar
• Richard Mojica
• Athena Mae Penuliar Molina

• Physical Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.