MAHMOOD FATHOLLAZADEH PA-C
NPI 1386711158
Physician Assistant in Colton, CA

Q: What is Mahmood Fathollazadeh's NPI number?

The NPI number for Mahmood Fathollazadeh is 1386711158. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Q: What is Mahmood Fathollazadeh's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since November 29, 2006PECOS EnrolledAccepts Medicare Assignment

1850 E WASHINGTON ST, COLTON, CA 92324(909) 887-2991(909) 887-5694 Get Directions Write a Review

NPPES record last updated: July 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Mahmood Fathollazadeh Pa-c NPPES

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

MAHMOOD FATHOLLAZADEH PA-C (NPI 1386711158) is an individual physician assistant in Colton, California, licensed in California (PA12070) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fontana, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1386711158

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMAHMOOD FATHOLLAZADEHCredential: PA-C

Location Address1850 E WASHINGTON STColton, CA 92324-4621

Mailing Address1850 E Washington StColton, CA 92324-4621 · (909) 887-2991 · Fax (909) 887-5694

Phone(909) 887-2991

Fax(909) 887-5694

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateNovember 29, 2006

Last NPPES UpdateJuly 18, 2023

NPPES CertifiedJuly 18, 2023

✔ NPI 1386711158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA12070

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1850 E WASHINGTON ST, Colton, CA 92324

Open in Google Maps ↗

Secondary Practice Location 1

Location 19961 Sierra AveFontana, CA 92335-6720 · Phone (909) 427-3910

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

Mahmood Fathollazadeh Pa-c 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 ID5496943821

PECOS Enrollment IDI20101229000169

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

438 services186 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

39 services37 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92324 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Leave this field empty

Other Providers at the Same Location NPPES 15

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

MR. ERIC SONG PA-C

Physician Assistant