Organization Active NPI

Institute of Neurological Surgery

  • Neurological Surgery Physician
  • Palmdale, CA
National Provider Identifier
1063635126
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
INSTITUTE OF NEUROLOGICAL SURGERY
Practice address
615 W Avenue Q
Suite D
Palmdale, CA 93551-3887
Phone
(661) 266-4500
Fax
(661) 266-4502
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Dr. Amir Shahram Makoui, M.D.NPI 1053426700
Title
President
Phone
(310) 498-1608

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X CA

Addresses

Primary practice location

615 W Avenue Q
Suite D
Palmdale, CA 93551-3887

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070515000642 CA Part B Supplier - Clinic/Group Practice 5294832879 Receives reassigned benefits from 1 practitioner
Practice locations: Palmdale, CA
O20100930068450 CA DME Supplier - Physician - Neurosurgery 5294832879 Practice locations: Palmdale, CA

National Provider Directory

National Provider Directory

Locations

44241 15th St W
Ste 105
Lancaster, CA 93534
Phone (661) 726-6373

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1063635126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W AVENUE Q",
            "address_2": "SUITE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513887",
            "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 W AVENUE Q",
            "address_2": "SUITE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513887",
            "telephone_number": "661-266-4500",
            "fax_number": "661-266-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF NEUROLOGICAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "MAKOUI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_middle_name": "SHAHRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-498-1608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.