NPIMap

Individual provider Active NPI

Ardavan Mashhadian, D.O.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1003132523
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A11899 Issued in CA
Practice address
1414 S Grand Ave Ste 100
Los Angeles, CA 90015-3071
Phone
(213) 537-0328
Fax
(213) 210-2400
NPI assigned
Apr 8, 2010
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A11899 CA Primary

Addresses

Primary practice location

1414 S Grand Ave Ste 100
Los Angeles, CA 90015-3071

Mailing address

1717 Malcolm Ave PH 1
Los Angeles, CA 90024-6842
Phone (213) 537-0328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140725000359 CA Practitioner - NephrologyPractitioner - Internal Medicine 6709002868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Western University of Health Sciences College of Dental Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3071
Phone (213) 537-0328

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.64
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A11899CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles Kidney Center, a Professional Medical Corporation Nephrology CurrentSince Jul 1, 2015 Accepting new patients
Los Angeles Kidney Center, a Professional Corporation Nephrology Current Accepting new patients
Dignity Community Care Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Northeast Hospital Corporation Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients

Locations

1127 Wilshire Blvd
Ste 510
Los Angeles, CA 90017
Phone (213) 250-1238

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

1414 S Grand Ave
Ste 100
Los Angeles, CA 90015
Phone (213) 481-2200

2021 S Flower St
Los Angeles, CA 90007
Phone (213) 745-4222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1003132523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MALCOLM AVE PH 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246842",
            "telephone_number": "213-537-0328",
            "fax_number": "213-210-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153071",
            "telephone_number": "213-537-0328",
            "fax_number": "213-210-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHHADIAN",
        "first_name": "ARDAVAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A11899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.