Individual provider Active NPI

Soroush Baghdadi, MD

  • Orthopaedic Surgery Physician
  • Santa Monica, CA
National Provider Identifier
1043899651
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A198984 Issued in CA
Practice address
1250 16TH St Ste 2100
Santa Monica, CA 90404-1249
Phone
(424) 259-6593
NPI assigned
Apr 2, 2021
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X MT224936 PA
Orthopaedic Surgery Physician 207X00000X A198984 CA Primary

Addresses

Primary practice location

1250 16TH St Ste 2100
Santa Monica, CA 90404-1249

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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
I20240923002727 CA Practitioner - Orthopedic Surgery 2264973833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1225 15TH St
Suite 2100
Santa Monica, CA 90404-1101
Phone (310) 319-1234

1250 16TH St
Santa Monica, CA 90404-1249

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198984CAMDOrthopaedic Surgery Physician
MT224936PAMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Orthopaedic Surgery CurrentSince Nov 1, 2024 Accepting new patients
Regents of the University of California Orthopaedic Surgery CurrentSince Nov 1, 2024 Accepting new patients
UCLA Medical Group Past Accepting new patients
Regents of the Univ of California Past Accepting new patients
Orthopaedic Hospital Past Accepting new patients

Locations

100 UCLA Medical Plz
Ste 170
Los Angeles, CA 90024
Phone (858) 534-3880

403 W Adams Blvd
Los Angeles, CA 90007
Phone (213) 741-8330

403 W Adams Blvd
Fl Third
Los Angeles, CA 90007

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 54206
Los Angeles, CA 90074

1111 W Inyokern Rd
Ste B
Ridgecrest, CA 93555
Phone (760) 301-6945

1225 15th St
Ste 2100
Santa Monica, CA 90404
Phone (310) 319-4000

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1250 16th St
Ste 2100
Santa Monica, CA 90404
Phone (424) 259-6593

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1043899651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST STE 2100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "424-259-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHDADI",
        "first_name": "SOROUSH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "PA",
            "license": "MT224936",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A198984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.