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

Individual provider Physical Therapist · NPI 1972463495

Mohamadreza Moghadam is a Physical Therapist in Private Practice in Costa Mesa, California. Qualified in 2025, 1 year ago. Practices with Prosport Physical Therapy Professionals Inc, a 94-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
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Practice location Address checks out

2777 Bristol St Ste B
Costa Mesa, CA 92626-5997
Phone: (949) 250-1112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 309233 (CA)

Record details

NPI number1972463495
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 17, 2025
Last updated in NPPESNovember 17, 2025
Certification dateNovember 17, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Prosport Physical Therapy Professionals Inc — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Costa Mesa