1. Home
  2. Directory
  3. Nevada
  4. Las Vegas
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

FARDAD MOSHTAGH SISAN DO
NPI 1841975679
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since June 20, 2023PECOS Enrolled
620 SHADOW LN, LAS VEGAS, NV 89106(702) 388-8437 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fardad Moshtagh Sisan Do NPPES

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

FARDAD MOSHTAGH SISAN DO (NPI 1841975679) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841975679
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameFARDAD MOSHTAGH SISANCredential: DO
Location Address620 SHADOW LNLas Vegas, NV 89106-4119
Mailing Address620 Shadow LnLas Vegas, NV 89106-4119
Phone(702) 388-8437
Sole ProprietorNo
Enumeration DateJune 20, 2023
NPPES CertifiedJune 20, 2023
✔ NPI 1841975679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
620 SHADOW LN, Las Vegas, NV 89106
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fardad Moshtagh Sisan Do 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.

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.

JANN STACEY PICKENS NP
Nurse Practitioner
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4506
DR. VICTOR HOANG D.O.
Orthopaedic Surgery
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. KAY E MCMILLAN DO
Emergency Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4500
DR. FELIX ALEXIE DO
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
ALEX HIRSCHFELD GOLDBACH MD
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 477-6572
NASIBO KADIR MD PLLC
Internal Medicine
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000
DR. JOHN YOUNG KO DO
Internal Medicine (Gastroenterology)
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-8436
DR. NICHOLAS CIURCZAK DO
Student in an Organized Health Care Education/Training Program
620 SHADOW LN
LAS VEGAS, NV 89106
Clark County (702) 388-4000

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 Fardad Moshtagh Sisan's NPI number?

The NPI number for Fardad Moshtagh Sisan is 1841975679. It was assigned to this individual provider in the NPPES registry on June 20, 2023.

Where is Fardad Moshtagh Sisan located?

Fardad Moshtagh Sisan practices at 620 Shadow Ln, Las Vegas, NV 89106. The listed phone number is (702) 388-8437.

What is Fardad Moshtagh Sisan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Fardad Moshtagh Sisan enrolled in Medicare?

Yes. Fardad Moshtagh Sisan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fardad Moshtagh Sisan was last updated on June 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.