Individual provider Active NPI

Jabeen Fatima, M.D

  • Family Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1043392186
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C53794 Issued in CA
Practice address
4955 Van Nuys Blvd
Suite 415
Sherman Oaks, CA 91403-1801
Phone
(818) 528-1080
Fax
(818) 528-1255
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12685R LA
Family Medicine Physician 207Q00000X C53794 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd
Suite 415
Sherman Oaks, CA 91403-1801

Mailing address

4955 Van Nuys Blvd
Suite 415
Sherman Oaks, CA 91403-1801
Phone (818) 528-1080

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
I20100506001061 CA Practitioner - Family Practice 3476447020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4955 Van Nuys Blvd
415 Jabeen Fatima MD
Sherman Oaks, CA 91403-1827
Phone (818) 528-1080

Hospital & facility affiliations

  • Home Health 4U, Inc Home health agency, Granada Hills, CA, CCN 059031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C53794CAMDFamily Medicine Physician
12685RLAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Molani Medical Group a Professional Medical Corp. Family Medicine CurrentSince Apr 1, 2010 Accepting new patients
Molani Family Practice Clinic PastSince Apr 1, 2003 Accepting new patients

Locations

4955 Van Nuys Blvd
Ste 415
Sherman Oaks, CA 91403
Phone (818) 501-5686

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jabeen.fatima.1@9056.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9056/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1043392186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 415",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-528-1080",
            "fax_number": "818-528-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 415",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-528-1080",
            "fax_number": "818-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATIMA",
        "first_name": "JABEEN",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "12685R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C53794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.