Individual provider Active NPI

Mahrokh Shayanpour, MD

  • Addiction Psychiatry Physician
  • Denver, CO
National Provider Identifier
1992120935
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
0058512 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204
Phone
(303) 602-6386
NPI assigned
Feb 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 0058512 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204

Mailing address

777 Bannock St
Denver, CO 80204-4507
Phone (303) 602-6386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20211206000496 NY Practitioner - Psychiatry 7517239197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0058512COMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 10, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Sep 10, 2021 Accepting new patients

Locations

2058 Jerome Ave
Bronx, NY 10453
Phone (917) 564-8731

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mshayanpou@montefioredirect.com

Organizations & group practices 2

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": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1992120935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-602-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "303-602-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYANPOUR",
        "first_name": "MAHROKH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CO",
            "license": "0058512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.