DR. MOHAMMED MORTAZAVI (NPI# 1871740241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871740241 |
| Entity Type | Individual |
| Full Name | DR. MOHAMMED MORTAZAVI |
| Credential | MD |
| Practice Address |
5199 E Farness Dr Ste 101 Tucson AZ 85712 |
| Mailing Address |
5199 E Farness Dr Ste 101 Tucson AZ 85712-2262 |
| Practice Telephone | 5202228076 |
| Practice Fax Number | 5203007156 |
| Mailing Telephone | 5202228076 |
| Mailing Fax Number | 5203007156 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2020-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
49421 | AZ | Allopathic & Osteopathic Physicians |
| N | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
49421 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | NPI | 1871740241 | 01 |
| AZ | 923231 | 05 |
| Street Address |
5199 E FARNESS DR STE 101 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952876815 | Monica Cecelia Pita | Specialist/Technologist | 5199 E Farness Dr Ste 101, Tucson, AZ 85712-2262 | 2018-10-08 |
| 1104274430 | Brett Dusenberry | Pediatrics | 5199 E Farness Dr Ste 101, Tucson, AZ 85712-2262 | 2016-05-26 |
| 1225484678 | Arvind Balaji | Pediatrics | 5199 E Farness Dr Ste 101, Tucson, AZ 85712-2262 | 2016-05-04 |
| 1235528613 | Leslie Streeter | Nurse Practitioner | 5199 E Farness Dr Ste 101, Tucson, AZ 85712 | 2015-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
| 1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
| 1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
| 1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
| 1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
| 1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
| Find all providers in zip 85712 | ||||
| Taxonomy Code | 2080S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Sports Medicine |
| A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184790214 | Michael Ralph Stilson | Pediatrics | 1224 E Lowell, Tucson, AZ 85721-0001 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669480968 | Peterson Pt LLC | Pediatrics | 1320 W Iron Springs Rd, Prescott, AZ 86305-1414 | 2006-08-03 |
| 1366723280 | Solstice Pediatrics and Sports Medicine, Plc | Pediatrics | 4731 S White Mountain Rd, Show Low, AZ 85901-7818 | 2011-09-06 |
| 1043473614 | Kristina Marie Wilson | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2008-07-03 |
| 1760696025 | Arizona Sports Medicine Consultants PC | Pediatrics | 4530 N 32nd St, # 102, Phoenix, AZ 85018 | 2007-05-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.