Individual provider Active NPI

Pejvak Sassani, M.D.

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1023292851
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A99917 Issued in CA
Practice address
4900 W Sunset Blvd FL 2
Los Angeles, CA 90027-5814
Phone
(323) 783-7262
Fax
(323) 783-7272
NPI assigned
Dec 28, 2007
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A99917 CA Primary

Addresses

Primary practice location

4900 W Sunset Blvd FL 2
Los Angeles, CA 90027-5814

Mailing address

4900 W Sunset Blvd FL 2
Los Angeles, CA 90027-5814
Phone (323) 783-7262

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000158 CA Practitioner - UrologyPractitioner - Neurosurgery 3577627447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: Neurosurgery
Education
University of California, San Diego School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

615 W Ave L
Lancaster, CA 93534-7211
Phone (661) 729-7100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 8, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 8, 2010 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4900 W Sunset Blvd
Fl 2
Los Angeles, CA 90027
Phone (323) 783-5500

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1023292851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 W SUNSET BLVD FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275814",
            "telephone_number": "323-783-7262",
            "fax_number": "323-783-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W SUNSET BLVD FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275814",
            "telephone_number": "323-783-7262",
            "fax_number": "323-783-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSANI",
        "first_name": "PEJVAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A99917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 N 15th St",
            "city": "LANCASTER",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.