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DR. TIRBOD TODD FATTAHI M.D. , DDS
NPI 1093780603
Oral & Maxillofacial Surgery in Jacksonville, FL

Active since February 18, 2006PECOS EnrolledAccepts Medicare Assignment
81.9/100
CMS Quality Rating
655 W 8TH ST, UFJP ORAL SURGERY, JACKSONVILLE, FL 32209(904) 244-3901(904) 244-3218 Get Directions Write a Review

NPPES record last updated: April 29, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Tirbod Todd Fattahi M.d. , Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIRBOD TODD FATTAHI M.D. , DDS (NPI 1093780603) is an individual oral & maxillofacial surgery provider in Jacksonville, Florida, licensed in Florida (ME85119) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Shands Jacksonville, and is a graduate of University Of Kentucky College Of Medicine (1999).

NPPES Registry Identity

NPI1093780603
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. TIRBOD TODD FATTAHICredential: M.D. , DDS
Location Address655 W 8TH ST, UFJP ORAL SURGERYJacksonville, FL 32209-6511
Mailing AddressPo Box 44008, Ufjp Provider EnrollmentJacksonville, FL 32231-4008
Phone(904) 244-3901
Fax(904) 244-3218
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1999
Enumeration DateFebruary 18, 2006
Last NPPES UpdateApril 29, 2008
✔ NPI 1093780603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in FL · ME85119
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentistTaxonomy 122300000X · License DTP368 (FL)
655 W 8TH ST, Jacksonville, FL 32209
Open in Google Maps ↗

Other Identifiers 6

Medicaid0752941-00FL
Medicaid000947339CGA
Medicare UPINH66373FL
Medicaid2644371-00FL
Medicare PIN190010416FL
Medicare PIN17581ZFL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tirbod Todd Fattahi M.d. , Dds is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577747393
PECOS Enrollment IDI20110401000786
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100001
Location655 W 8th StJacksonville, FL 32209 · Duval County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.43
Promoting Interoperability100
Improvement Activities40
Cost59.59

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW DUWAIN WARRICK M.D.
Anesthesiology
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-4195
DR. MARYAM OOJA ABUBAKAR MD, MPH
Pediatrics (Neonatal-Perinatal Medicine)
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-3508
CHRISTOPHER FULLER PT, DPT
Physical Therapist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411
SHANTELL MONIQUE BROWN
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-5774
WILLIAM RENFRO PHARM. D.
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-2179
CAM-TU NGUYEN PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (352) 682-4355
LOGAN SMITH PHARMD
Pharmacist
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (478) 387-5570
HANNAH BISOGLIO
Student in an Organized Health Care Education/Training Program
655 W 8TH ST
JACKSONVILLE, FL 32209
Duval County (904) 244-0411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tirbod Fattahi's NPI number?

The NPI number for Tirbod Fattahi is 1093780603. It was assigned to this individual provider in the NPPES registry on February 18, 2006.

Where is Tirbod Fattahi located?

Tirbod Fattahi practices at 655 W 8th St Ufjp Oral Surgery, Jacksonville, FL 32209. The listed phone number is (904) 244-3901.

What is Tirbod Fattahi's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Tirbod Fattahi enrolled in Medicare?

Yes. Tirbod Fattahi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tirbod Fattahi accept?

Health plans from AvMed, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental and 4 other insurers list Tirbod Fattahi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tirbod Fattahi affiliated with any hospitals?

According to CMS data, Tirbod Fattahi is affiliated with Shands Jacksonville.

When was this NPI record last updated?

The NPPES record for Tirbod Fattahi was last updated on April 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.