Organization Active NPI

International Center for Minimally Invasive Foot Surgery

  • Foot & Ankle Surgery Podiatrist
  • Woodland Hills, CA
National Provider Identifier
1083074579
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4728 Issued in CA
Legal business name
INTERNATIONAL CENTER FOR MINIMALLY INVASIVE FOOT SURGERY
Practice address
23164 Ventura Blvd
Woodland Hills, CA 91364-1101
Phone
(818) 914-5686
Fax
(818) 408-2452
NPI assigned
Feb 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Dr. Alireza Khosroabadi, DPMNPI 1841490620
Title
Ceo
Phone
(818) 408-2800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4728 CA Primary

Addresses

Primary practice location

23164 Ventura Blvd
Woodland Hills, CA 91364-1101

Mailing address

23164 Ventura Blvd
Woodland Hills, CA 91364-1101
Phone (818) 914-5686

Other identifiers 2

IdentifierTypeStateIssuer
E4728OtherCALICENSE
1841490620OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106000646 CA Part B Supplier - Clinic/Group Practice 7113337924 Receives reassigned benefits from 6 practitioners
Practice locations: Woodland Hills, CA

National Provider Directory

National Provider Directory

Locations

23164 Ventura Blvd
Ste C
Woodland Hills, CA 91364
Phone (818) 629-8988

23164 Ventura Blvd
Woodland Hls, CA 91364
Phone (818) 914-5686

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1083074579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23164 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641101",
            "telephone_number": "818-914-5686",
            "fax_number": "818-914-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23164 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641101",
            "telephone_number": "818-914-5686",
            "fax_number": "818-408-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL CENTER FOR MINIMALLY INVASIVE FOOT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "KHOSROABADI",
        "authorized_official_first_name": "ALIREZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-408-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E4728",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841490620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.