Individual provider Active NPI

Alfred Robenzadeh, MD

  • Child & Adolescent Psychiatry Physician
  • Pasadena, CA
National Provider Identifier
1083972509
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A149046 Issued in CA
Practice address
940 Avenue 64
Pasadena, CA 91105-2711
Phone
(323) 254-2274
NPI assigned
May 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 280380 NY
Child & Adolescent Psychiatry Physician 2084P0804X 280380 NY
General Practice Physician 208D00000X 280380 NY
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X A149046 CA Primary

Addresses

Primary practice location

940 Avenue 64
Pasadena, CA 91105-2711

Mailing address

815 Colorado Blvd Ste 300
Los Angeles, CA 90041-1744
Phone (323) 543-2800

Other practice location 1

1449 Lexington Ave Ste 2E
New York, NY 10128
Phone (516) 491-0064

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
I20250226001360 CA Practitioner - Psychiatry 1759811771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9454 Wilshire Blvd
Suite PH24
Beverly Hills, CA 90212-2931
Phone (310) 848-8505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149046CAMDChild & Adolescent Psychiatry Physician
280380NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aretehealth Psychiatry CurrentSince Oct 25, 2024 Accepting new patients
Arete Health PLLC Child & Adolescent Psychiatry Past Accepting new patients

Locations

324 S Beverly Dr
Beverly Hills, CA 90212
Phone (310) 463-2444

9454 Wilshire Blvd
Ph
Beverly Hills, CA 90212
Phone (310) 848-8505

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.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1083972509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 COLORADO BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411744",
            "telephone_number": "323-543-2800",
            "fax_number": "323-978-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 AVENUE 64",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052711",
            "telephone_number": "323-254-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1449 Lexington Ave Ste 2E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10128",
            "country_code": "US",
            "telephone_number": "516-491-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBENZADEH",
        "first_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "280380",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "280380",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "280380",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A149046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.