DR. MARYAM DOLATSHAHI M.D.
NPI 1992053581
Student in an Organized Health Care Education/Training Program in San Jose, CA

Active since August 29, 2012PECOS EnrolledAccepts Medicare Assignment
455 OCONNOR DR STE 250, SAN JOSE, CA 95128(530) 750-9742 Get Directions Write a Review

NPPES record last updated: June 17, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Maryam Dolatshahi M.d. NPPES

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

DR. MARYAM DOLATSHAHI M.D. (NPI 1992053581) is an individual student in an organized health care education/training program in San Jose, California and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2014).

NPPES Registry Identity

NPI1992053581
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. MARYAM DOLATSHAHICredential: M.D.
Location Address455 OCONNOR DR STE 250San Jose, CA 95128-1644
Mailing Address455 Oconnor Dr Ste 250San Jose, CA 95128-1644 · (530) 750-9742
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2014
Enumeration DateAugust 29, 2012
Last NPPES UpdateJune 17, 2014
NPI 1992053581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.
455 OCONNOR DR STE 250, San Jose, CA 95128

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

Dr. Maryam Dolatshahi M.d. 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 ID4284990540
PECOS Enrollment IDI20171102002345
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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
47 services22 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
19 services19 patients

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers18 claims26 services$5.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Family Medicine
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Family Medicine
455 OCONNOR DR STE 250
SAN JOSE, CA 95128
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 250
SAN JOSE, CA 95128

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 Maryam Dolatshahi's NPI number?

The NPI number for Maryam Dolatshahi is 1992053581. It was assigned to this individual provider in the NPPES registry on August 29, 2012.

Where is Maryam Dolatshahi located?

Maryam Dolatshahi practices at 455 Oconnor Dr Ste 250, San Jose, CA 95128. The listed phone number is (530) 750-9742.

What is Maryam Dolatshahi's specialty?

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

Is Maryam Dolatshahi enrolled in Medicare?

Yes. Maryam Dolatshahi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Maryam Dolatshahi was last updated on June 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.