NPIMap

Organization Active NPI

Peyman Banooni MD Inc

  • Obstetrics & Gynecology Physician
  • Beverly Hills, CA
National Provider Identifier
1013187863
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A75080 Issued in CA
Legal business name
PEYMAN BANOONI MD INC
Practice address
150 N Robertson Blvd
Suite 200
Beverly Hills, CA 90211-2142
Phone
(310) 652-9347
Fax
(310) 652-3489
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Peyman Banooni, MDNPI 1811002777
Title
President
Phone
(310) 652-9347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A75080 CA Primary

Addresses

Primary practice location

150 N Robertson Blvd
Suite 200
Beverly Hills, CA 90211-2142

Mailing address

150 N Robertson Blvd
Suite 200
Beverly Hills, CA 90211-2142
Phone (310) 652-9347

Other identifiers 3

IdentifierTypeStateIssuer
00A750801MedicaidCA
00A750802MedicaidCA
WA75080AOtherRENDERING NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616001582 CA Part B Supplier - Clinic/Group Practice 4789668609 Receives reassigned benefits from 3 practitioners
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1013187863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-652-9347",
            "fax_number": "310-652-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-652-9347",
            "fax_number": "310-652-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEYMAN BANOONI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "BANOONI",
        "authorized_official_first_name": "PEYMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-652-9347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A75080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A750801",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A750802",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING NUMBER",
            "identifier": "WA75080A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.