DR. MARYAM HASSANPOUR (D.O.) – Internal Medicine Physician, NPI 1154742831

DR. MARYAM HASSANPOUR (D.O.) is a healthcare provider. based in San jose, California. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 20A6615 (CA). The NPI Number for DR. MARYAM HASSANPOUR (D.O.) is 1154742831

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARYAM HASSANPOUR (D.O.)
NPI
1154742831
Phone
(408) 445-3400
Address
1333 Meridian Ave
Enumeration Date
23 December 2013
Last Update Date
9 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
40844534003730
Graduation Year
1993 (33 years ago)
PAC ID
7618196999
Group Practice PAC ID
1153406665
Professional Enrollment ID
I20140918001489
Address ID
CA951255212SA1333XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

Provider Addresses for DR. MARYAM HASSANPOUR (D.O.)

  • 1333 Meridian Ave

    San Jose, CA 951255212

    Phone: (408) 445-3400

    Type: Location

  • 455 OConnor Dr

    San Jose, CA 951281633

    Phone: (408) 283-7676

    Type: Location

  • 1642 E Capitol Expy

    San Jose, CA 951211800

    Phone: (408) 445-3431

    Type: Location

  • 2670 S WHITE RD STE 160

    SAN JOSE, CA 951482083

    Phone: (408) 826-7679

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-09-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140918001489IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95125)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153406665View full group profile
NameSpecialtyState
Internal MedicineCA
Family PracticeCA
Nurse PractitionerCA
Family PracticeCA
Family PracticeCA
Nurse PractitionerCA
Nurse PractitionerCA
Family Practice, Osteopathic Manipulative MedicineCA
Clinical PsychologistCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What number should I use to identify DR. MARYAM HASSANPOUR (D.O.) for billing?
Administrative and clinical systems typically use NPI 1154742831 for DR. MARYAM HASSANPOUR (D.O.).
Is DR. MARYAM HASSANPOUR (D.O.)'s NPI status active today?
Active status means DR. MARYAM HASSANPOUR (D.O.)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. MARYAM HASSANPOUR (D.O.)?
NPPES ties DR. MARYAM HASSANPOUR (D.O.) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit DR. MARYAM HASSANPOUR (D.O.) in San Jose, California?
For routing, start with San Jose, California for DR. MARYAM HASSANPOUR (D.O.), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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