DR. MORTEZA DOWLATSHAHI M.D.
NPI 1437112158
Radiology - Radiation Oncology in San Jose, CA
Quality Rating: 100 out of 100 score
NPI Status: Active since April 11, 2006
Contact Information
200 JOSE FIGUERES AVE
SUITE 199
SAN JOSE, CA
ZIP 95116
Phone: (408) 729-4673
Fax: (408) 729-7043
- Individual
- Male
- Years of Experience 32
- Radiology
- Radiation Oncology
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MORTEZA DOWLATSHAHI
This page provides the complete NPI Profile along with additional information for Morteza Dowlatshahi, a provider established in San Jose, California with a medical specialization in Radiology, focusing in radiation oncology and more than 32 years of experience. He graduated from University Of Kansas School Of Med (kc/wich/sal) in 1994. The healthcare provider is registered in the NPI registry with number 1437112158 assigned on April 2006. The practitioner's primary taxonomy code is 2085R0001X with license number A55256 (CA). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1437112158
- Provider Name
- DR. MORTEZA DOWLATSHAHI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 200 JOSE FIGUERES AVE SUITE 199 SAN JOSE, CA 95116
- Location Phone
- (408) 729-4673
- Location Fax
- (408) 729-7043
- Mailing Address
- 200 JOSE FIGUERES AVE SUITE 199 SAN JOSE, CA 95116
- Mailing Phone
- (408) 729-4673
- Mailing Fax
- (408) 729-7043
- Medical School Name
- UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
- Graduation Year
- 1994
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-11-2006
- Last Update Date
- 01-20-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Radiation Oncology
- Taxonomy Code
- 2085R0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A55256
- License State
- CA
- Taxonomy Description
- A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
H08406 | MEDICARE UPIN (02) | CA | |
00A552560 | MEDICARE PIN (08) | CA |
Medicare Participation & PECOS Enrollment Status
Morteza Dowlatshahi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Morteza Dowlatshahi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 8426183880
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20100324000424
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Colonoscopy
Ct guidance for insertion of radiation therapy fields
Established patient office or other outpatient visit, 30-39 minutes
Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session
New patient office or other outpatient visit, 60-74 minutes
A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.
This service was performed for 1-10 patientsCT guidance for insertion of radiation therapy fields involves using a CT scan to accurately map the area of your body where radiation will be applied. This ensures the radiation targets only the necessary area, minimizing impact to healthy tissues.
This service was performed 36 times for 11 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 41 times for 32 patientsIntensity-modulated radiation therapy (IMRT) is a type of cancer treatment. It uses advanced technology to manipulate photon beams of radiation to conform to the shape of a tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by modulating—or controlling—the intensity of the radiation beam. This can result in better tumor control and less harm to healthy tissue.
This service was performed 39 times for 11 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 17 times for 17 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $51.51 for a new patient copayment and $21.64 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 95116 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $206.04
- Minimum New Patient Price $70.37
- Maximum New Patient Price $206.04
- Average New Patient Copayment $51.51
- Minimum New Patient Copayment $17.59
- Maximum New Patient Copayment $51.51
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $86.56
- Minimum Established Patient Price $23.96
- Maximum Established Patient Price $169.6
- Average Established Patient Copayment $21.64
- Minimum Established Patient Copayment $5.99
- Maximum Established Patient Copayment $42.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 100 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 4 | 3 | 7 | 1 | 1 | 2 | 1 | 5 | 8 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 6 | 7 | 2 | 1 | 4 | 1 | 10 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 4 + 6 + 7 + 2 + 1 + 4 + 1 + 1 + 0 + 24 = 52 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 52 = 8 | 8 |
The NPI number 1437112158 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1053317818 | DR. RAYMOND W. LEE M.D. Individual | Internal Medicine (Hematology & Oncology) | 200 JOSE FIGUERES AVE STE 245 SAN JOSE, CA 95116 (408) 923-3388 |
1720086556 | DR. VINH QUY NGUYEN M.D. Individual | Internal Medicine | 200 JOSE FIGUERES AVE SUITE 460 SAN JOSE, CA 95116 (408) 254-1794 |
1609866862 | DR. KWONG K YAU M.D. Individual | Pediatrics | 200 JOSE FIGUERES AVE #300 SAN JOSE, CA 95116 (408) 254-8828 |
1790753408 | MR. RASHID SULTAN ELAHI M.D. Individual | Internal Medicine (Nephrology) | 200 JOSE FIGUERES AVE SUITE 270 SAN JOSE, CA 95116 (408) 937-9009 |
1871554147 | SURESH R NAYAK M.D. Individual | Obstetrics & Gynecology | 200 JOSE FIGUERES AVE SUITE 305 SAN JOSE, CA 95116 (408) 279-3692 |
1992760763 | PRASANNA L. KRISHNAMSHETTY M.D Individual | Legal Medicine | 200 JOSE FIGUERES AVE STE# 435 SAN JOSE, CA 95116 (408) 258-4244 |
1295761609 | DR. DARITH S. KHAY M.D. Individual | Family Medicine | 200 JOSE FIGUERES AVE SUITE 315 SAN JOSE, CA 95116 (408) 254-1500 |
1245254382 | NICOLE HONG PHUONG THAI M.D. Individual | Internal Medicine | 200 JOSE FIGUERES AVE SUITE 355 SAN JOSE, CA 95116 (408) 928-5656 |
1770593105 | DR. MOHAMMED HABEEB AHMED M.D. Individual | Internal Medicine (Interventional Cardiology) | 200 JOSE FIGUERES AVE SUITE 325 SAN JOSE, CA 95116 (408) 937-9000 |
1518977958 | CENTER FOR CARDIOVASCULAR CARE A MEDICAL CORPORATION Organization | Internal Medicine (Interventional Cardiology) | 200 JOSE FIGUERES AVE SUITE 325 SAN JOSE, CA 95116 (408) 937-9000 |
1043326226 | DR. NANG NGUYEN D.O. Individual | Surgery | 200 JOSE FIGUERES AVE SUITE 225 SAN JOSE, CA 95116 (408) 929-5610 |
1588770762 | DR. HUY T.T. NGUYEN D.O. Individual | Surgery | 200 JOSE FIGUERES AVE SUITE 225 SAN JOSE, CA 95116 (408) 929-5610 |
1386750438 | DR. DANNY B LUONG MD Individual | Ophthalmology | 200 JOSE FIGUERES AVE 350 SAN JOSE, CA 95116 (408) 923-8138 |
1689779746 | DR. FARDIS SHAHRIVAR MD Individual | Pediatrics | 200 JOSE FIGUERES AVE SUITE 295 SAN JOSE, CA 95116 (408) 729-4473 |
1790880409 | DARITH S. KHAY, MD, INC. Organization | Clinic/Center (Health Service) | 200 JOSE FIGUERES AVE SUITE 315 SAN JOSE, CA 95116 (408) 254-1500 |
1932291648 | JOHN HAU LIEN MD Individual | Internal Medicine (Cardiovascular Disease) | 200 JOSE FIGUERES AVE #330 SAN JOSE, CA 95116 (408) 251-7900 |
1154410322 | MANJARI ARAVAMUTHAN M.D Individual | Internal Medicine | 200 JOSE FIGUERES AVE 230 SAN JOSE, CA 95116 (408) 929-6922 |
1831369842 | SHAHID K SIDDIQUI MD INC Organization | Exclusive Provider Organization | 200 JOSE FIGUERES AVE STE 320 SAN JOSE, CA 95116 (408) 926-8100 |
1629242086 | SURESH R. NAYAK MD., INC. Organization | Clinic/Center | 200 JOSE FIGUERES AVE 305 SAN JOSE, CA 95116 (408) 279-3692 |
1376706929 | DR. LY VIET DO M.D. Individual | Radiology (Radiation Oncology) | 200 JOSE FIGUERES AVE #199 SAN JOSE, CA 95116 (408) 729-4673 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437112158, enumerated in the NPI registry as an "individual" on April 11, 2006
The provider is located at 200 Jose Figueres Ave Suite 199 San Jose, Ca 95116 and the phone number is (408) 729-4673
The provider's speciality is Radiology with taxonomy code 2085R0001X with a focus in Radiation Oncology
The provider has more than 32 years of experience. He graduated from University Of Kansas School Of Med (kc/wich/sal) in 1994.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.
Medicare beneficiaries should expect a typical cost of $206.04 with an average copayment of $51.51 for new patient appointments. Established patients should expect a typical charge of $86.56 and an average copayment of 21.64. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Colonoscopy, Ct guidance for insertion of radiation therapy fields, Established patient office or other outpatient visit, 30-39 minutes, Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session and New patient office or other outpatient visit, 60-74 minutes.
This NPI record was last updated on April 11, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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