DR. FEREYDOON MAHJOURI M.D.
NPI 1710095419
Specialist in Fridley, MN

Q: What is Fereydoon Mahjouri's NPI number?

The NPI number for Fereydoon Mahjouri is 1710095419. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Q: What is Fereydoon Mahjouri's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since August 25, 2006PECOS Enrolled

500 OSBORNE RD NE, SUITE 130, FRIDLEY, MN 55432(763) 780-2770(763) 780-2812 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Dr. Fereydoon Mahjouri M.d. NPPES

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

DR. FEREYDOON MAHJOURI M.D. (NPI 1710095419) is an individual specialist in Fridley, Minnesota, licensed in Minnesota (23415) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710095419

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. FEREYDOON MAHJOURICredential: M.D.

Location Address500 OSBORNE RD NE, SUITE 130Fridley, MN 55432-2765

Mailing Address500 Osborne Rd Ne, Suite 130Fridley, MN 55432-2765 · (763) 780-2770 · Fax (763) 780-2812

Phone(763) 780-2770

Fax(763) 780-2812

Sole ProprietorNo

Enumeration DateAugust 25, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1710095419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in MN · 23415

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

500 OSBORNE RD NE, Fridley, MN 55432

Open in Google Maps ↗

Other Identifiers 1

Medicare UPINA94506MN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Fereydoon Mahjouri 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.

Leave this field empty