VISTA S KHOSRAVI M.D.
NPI 1407868789
Dermatology in San Jose, CA

Active since August 13, 2006PECOS Enrolled
80 GREAT OAKS BLVD, SAN JOSE, CA 95119(408) 363-3000 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Vista S Khosravi M.d. NPPES

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

VISTA S KHOSRAVI M.D. (NPI 1407868789) is an individual dermatology provider in San Jose, California, licensed in California (G80120) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407868789
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameVISTA S KHOSRAVICredential: M.D.
Location Address80 GREAT OAKS BLVDSan Jose, CA 95119-1310
Mailing Address1606 Montellano CtSan Jose, CA 95120-4833 · (408) 927-9938
Sole ProprietorYes
Enumeration DateAugust 13, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1407868789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in CA · G80120
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
80 GREAT OAKS BLVD, San Jose, CA 95119

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Vista S Khosravi M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95119 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
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
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.

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.

Clinic/Center (VA)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Social Worker (Clinical)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Social Worker
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Nurse Practitioner (Gerontology)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Internal Medicine
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Social Worker (Clinical)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Social Worker (Clinical)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119
Psychiatry & Neurology (Psychiatry)
80 GREAT OAKS BLVD
SAN JOSE, CA 95119

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 Vista Khosravi's NPI number?

The NPI number for Vista Khosravi is 1407868789. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is Vista Khosravi located?

Vista Khosravi practices at 80 Great Oaks Blvd, San Jose, CA 95119. The listed phone number is (408) 363-3000.

What is Vista Khosravi's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Vista Khosravi enrolled in Medicare?

Yes. Vista Khosravi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Vista Khosravi was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.