DR. NASIM KHOSRAVI FOROUTAN (MD) – Internal Medicine Physician, NPI 1649775289
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
21,511 INTERNAL MEDICINE in CA
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Provider Addresses for DR. NASIM KHOSRAVI FOROUTAN (MD)
2725 PAVILION PKWY APT 2314
TRACY, CA 953049495
Phone: (832) 417-8025
Type: Mailing
University of California, Davis Medical Center, 2315, Stockton Boulevard, Sacramento, Sacramento County, California, 95817, United States
SACRAMENTO, CA 958172201
Phone: (916) 734-2011
Type: Location
978 N ALDER ST
CANBY, OR 970133369
Phone: (832) 417-8025
Type: Mailing
700 LAWRENCE EXPY
SANTA CLARA, CA 950515173
Phone: (408) 851-1000
Type: Location
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: 2025-10-23
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251023002287 | I | Internal Medicine | CA | TBD |
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.
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 95304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Critical Care (Intensivists) | FL | |
| Internal Medicine, Critical Care (Intensivists) | CA | |
| Internal Medicine, Pediatric Medicine | CA | |
| - | CA | |
| - | CA | |
| Critical Care (Intensivists), Pulmonary Disease | CA | |
| - | CA | |
| Internal Medicine, Pulmonary Disease, Critical Care (Intensivists) | CA | |
| - | CA | |
| - | CA |
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