Mariam Shanaz Amiri, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E4049 Issued in CA

Practice address

11332 Mountain View Ave
Suite a
Loma Linda, CA 92354-3854

Phone

(909) 796-3707

Fax

(909) 796-3709

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mariam AmiriGroup PAC ID 0446158968, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brightlane Healthcare, Inc. Home health agency, Montclair, CA, CCN 559655
• Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Mariam Amiri

  • Podiatrist
  • Apple Valley, CA
  • NPI 1235140336
  Medicare reassignment Care Compare group Authorized official
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brightlane Healthcare Inc

  • Home Health Agency
  • Montclair, CA
  • NPI 1487203832
  Care Compare affiliation
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1093826539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1059",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541059",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11332 MOUNTAIN VIEW AVE",
            "address_2": "SUITE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543854",
            "telephone_number": "909-796-3707",
            "fax_number": "909-796-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRI",
        "first_name": "MARIAM",
        "middle_name": "SHANAZ",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E40490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Amen
• American Surgical Medical Supply Inc
• Mohammd Reza Amini, M.D.
• Sanaz Amini, M.D.
• Mojtaba Thomas Aminikharrazi Jr., PA
• Dante Remington Amodeo, TRAINEE
• Ji Hyun An
• Sang-Gyoon Timothy An
• Apoorva Anandan
• Michael Andaya, MD

• Podiatrist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.