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

Mohammad Akhavan Heidari, MD

Individual provider Surgery Physician · NPI 1205041571

Mohammad Akhavan Heidari, MD is a General Surgery in Fort Defiance, Arizona. Qualified in 1993, 33 years ago. Practices with Acute Care Surgical Affiliates of Texas PA, a 43-clinician group and accepts Medicare assignment. Licensed in Arizona, California, Florida and Pennsylvania and 1 more.

Years since qualifying
33
Licensed in
AZ, CA, FL, PA, WV
In the registry since
2007
Specialties on file
6
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

Corner Of Route N12 And N7
Fort Defiance, AZ 86504
Phone: (928) 729-8132
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 45679 (AZ)
Surgery Physician Taxonomy 208600000X · Licence A108305 (CA)
Surgery Physician Taxonomy 208600000X · Licence ME112102 (FL)
Surgery Physician Taxonomy 208600000X · Licence MD437802 (PA)
Surgery Physician Taxonomy 208600000X · Licence MT196167 (PA)
Surgery Physician Taxonomy 208600000X · Licence 24783 (WV)

Record details

NPI number1205041571
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 11, 2007
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026
Mailing addressPo Box 649, Fort Defiance, AZ 86504-0649

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Acute Care Surgical Affiliates Of Texas Pa — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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