MAVIE CLINIC PROFESSIONAL NURSING CORPORATION
NPI 1245189190
Nurse Practitioner - Family in Patterson, CA
About Mavie Clinic Professional Nursing Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAVIE CLINIC PROFESSIONAL NURSING CORPORATION (NPI 1245189190), doing business as Mavie Clinic, is a healthcare organization registered as a family in Patterson, California and active in the NPI registry since January 2026. The organization lists Mukhtar Kohistani, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mavie Clinic Professional Nursing Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mavie Clinic Professional Nursing Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Mavie Clinic Professional Nursing Corporation's NPI number?
The NPI number for Mavie Clinic Professional Nursing Corporation is 1245189190. It was assigned to this organization in the NPPES registry on January 23, 2026. The provider is doing business as Mavie Clinic.
Where is Mavie Clinic Professional Nursing Corporation located?
Mavie Clinic Professional Nursing Corporation is located at 109 Portrait Ln, Patterson, CA 95363. The listed phone number is (209) 806-4841.
What is Mavie Clinic Professional Nursing Corporation's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mavie Clinic Professional Nursing Corporation enrolled in Medicare?
Yes. Mavie Clinic Professional Nursing Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mavie Clinic Professional Nursing Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mavie Clinic Professional Nursing Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mavie Clinic Professional Nursing Corporation was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.
# Mavie Clinic Professional Nursing Corporation · NPI 1245189190
Family organization in Patterson, California. Organization record, active in the CMS NPPES registry since January 23, 2026.
## Identity
- **NPI:** 1245189190 (Entity type: Organization)
- **Enumerated:** January 23, 2026
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** Mavie Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Mukhtar Kohistani, PRESIDENT
## Practice location
- **Address:** 109 PORTRAIT LN, Patterson, CA 95363-8341
- **Phone:** (209) 806-4841 · **Fax:** (209) 290-3320
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1245189190) · Data from the CMS NPPES public registry.