Individual provider Active NPI

Amir Shahram Makoui, MD

  • Neurological Surgery Physician
  • Palmdale, CA
National Provider Identifier
1053426700
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A75531 Issued in CA
Practice address
615 West Ave Q Suite D
Palmdale, CA 93551
Phone
(661) 266-4500
Fax
(661) 266-4502
NPI assigned
Aug 21, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A75531 CA Primary

Addresses

Primary practice location

615 West Ave Q Suite D
Palmdale, CA 93551

Mailing address

PO Box 4008
Lancaster, CA 93539-4008
Phone (661) 266-4500

Other identifiers 1

IdentifierTypeStateIssuer
OOA755310OtherCABLUESHIELD

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
I20070515000649 CA Practitioner - Neurosurgery 0749387322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
George Washington University School of Medicine, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

615 W Ave Q
Suite D
Palmdale, CA 93551-3887
Phone (661) 266-4500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion58
Laminectomy or laminotomy (partial removal of spine bones)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75531CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Neurological Surgery Neurological Surgery CurrentSince Sep 1, 2001 Accepting new patients

Locations

615 W Avenue Q
Ste D
Palmdale, CA 93551
Phone (661) 266-4500

Organizations & group practices 1

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 4

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053426700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935394008",
            "telephone_number": "661-266-4500",
            "fax_number": "661-266-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WEST AVE Q SUITE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93551",
            "telephone_number": "661-266-4500",
            "fax_number": "661-266-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOUI",
        "first_name": "AMIR",
        "middle_name": "SHAHRAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A75531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "OOA755310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.