Active NPI
Kaveh Homayoon, MD
- Urology Physician
- Phoenix, AZ
National Provider Identifier
1982615159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD61374266
- Practice address
- 2601 E Roosevelt St
Phoenix, AZ 85008-4973 - Phone
- (602) 344-5371
- Fax
- (602) 344-1903
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 35912 | AZ | |
| Urology Physician | 208800000X | MD61374266 | WA | Primary |
Addresses
Primary practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000
Other practice location 1
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 814-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126121 | Medicaid | AZ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | khomayoon41571@skagit.direct-ci.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- khomayoon18293@direct.valleywisehealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669075200000",
"number": "1982615159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850168034",
"telephone_number": "602-470-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 E ROOSEVELT ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850084973",
"telephone_number": "602-344-5371",
"fax_number": "602-344-1903"
}
],
"practiceLocations": [
{
"address_1": "1400 E Kincaid St",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "WA",
"postal_code": "982744127",
"country_code": "US",
"telephone_number": "360-814-6565",
"fax_number": "360-814-6380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOMAYOON",
"first_name": "KAVEH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2022-11-22",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "AZ",
"license": "35912",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WA",
"license": "MD61374266",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126121",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khomayoon41571@skagit.direct-ci.com",
"affiliation": "N",
"endpointDescription": "Provider Direct Message",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1400 E Kincaid St",
"city": "Mount Vernon",
"state": "WA",
"country_code": "US",
"postal_code": "982744127",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.