MEHRDAD M.R. AMIRHAMZEH, M.D. — NPI 1174523096 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) in MANTECA, CA)

CMS-1500 Box 24J / 33a • NPI

1174523096

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208G00000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)

Box 32 Service Location & ZIP+4

1610 W YOSEMITE AVE, SUITE 3, MANTECA, CA, 95337-5189

✓ 9-Digit EDI 837 ZIP+4 (95337-5189)

Practice Phone & Referral Fax

(209) 665-4412

Fax: (209) 665-4415

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174523096 (MEHRDAD M.R. AMIRHAMZEH, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174523096` (NPI-1 Individual Practitioner)
Provider / Legal Name	MEHRDAD M.R. AMIRHAMZEH, M.D.
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery) NUCC Code: `208G00000X` (Thoracic Surgery (Cardiothoracic Vascular Surgery))
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1610 W YOSEMITE AVE, SUITE 3, MANTECA, CA, 95337-5189
Practice Telephone / Fax	Tel: (209) 665-4412 \| Fax: (209) 665-4415
Administrative Mailing Address	1610 W YOSEMITE AVE, MANTECA, CA, 95337-5189
Enumeration & Last Sync	Enumerated: 2005-07-21 \| CMS Record Updated: 2022-08-19

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1610 W YOSEMITE AVE, SUITE 3, MANTECA, CA, 95337-5189

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Plain-English Taxonomy & CMS Crosswalk (208G00000X)

What Does Taxonomy Code 208G00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208G00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 33 (Physician/Thoracic Surgery) • CMS Code 78 (Physician/Cardiac Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Thoracic Surgery (Cardiothoracic Vascular Surgery) for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MEHRDAD M.R. AMIRHAMZEH, M.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208G00000X` — Thoracic Surgery (Cardiothoracic Vascular Surgery) Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)	State: CA \| License: `G86572` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MEHRDAD M.R. AMIRHAMZEH, M.D. (NPI #1174523096)