MARJAN MOGHADDAM (D.O) – Family Medicine Physician, NPI 1457615247
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
164 GENERAL PRACTICE in GA
Provider Addresses for MARJAN MOGHADDAM (D.O)
10203 MERRICK DR
PEACHTREE CITY, GA 302696690
Phone: (248) 595-2328
Type: Mailing
48 MAIN ST
SUITE 3A
SENOIA, GA 302761895
Phone: (678) 723-0400
Type: Location
4077 CROOKS RD
ROYAL OAK, MI 480732481
Phone: (248) 595-2328
Type: Mailing
3370 E JEFFERSON AVE
DETROIT, MI 482074236
Phone: (800) 659-6568
Fax: (313) 656-1610
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: 2015-08-14
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 |
|---|---|---|---|---|
| I20150814013090 | I | General Practice | MI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 76 | 65 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 46 | 45 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 13 | 13 | $0 |
Insurance plans in this area (ZIP 30269)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
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