Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Farzad Modaress Moussavi, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366749137

Farzad Modaress Moussavi, MD is an Internal Medicine in Bay Shore, New York. Qualified in 1994, 32 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in District of Columbia.

Years since qualifying
32
Licensed in
DC
In the registry since
2011
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

40 E Main St
Bay Shore, NY 11706-8301
Phone: (631) 376-6075
Fax: (631) 376-6091
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD041637 (DC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Hospitalist Physician Taxonomy 208M00000X · Licence MD041637 (DC)

Record details

NPI number1366749137
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 14, 2011
Last updated in NPPESDecember 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesINFECTIOUS DISEASE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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