Ali R Namazie MD a Medical Group, Inc

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

Legal business name

ALI R NAMAZIE MD A MEDICAL GROUP, INC

Practice address

16661 Ventura Blvd Ste 226
Encino, CA 91436-1947

Phone

(818) 986-5500

Fax

(818) 986-5503

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Ali R Namazie, MDNPI 1184603102

Title

Practice President

Phone

(818) 986-5500

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Ali R Namazie, MD

  • Otolaryngology Physician
  • Encino, CA
  • NPI 1184603102
  Medicare reassignment Authorized official
• Ryan Michelle Jordan, PA

  • Physician Assistant
  • Sherman Oaks, CA
  • NPI 1942481742
  Medicare reassignment NPD

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1104046747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD",
            "address_2": "SUITE 505",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031801",
            "telephone_number": "818-986-5500",
            "fax_number": "818-986-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 226",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361947",
            "telephone_number": "818-986-5500",
            "fax_number": "818-986-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI R NAMAZIE MD A MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "NAMAZIE",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE PRESIDENT",
        "authorized_official_telephone_number": "818-986-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A602910",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A602910",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@drnamazie.com",
            "affiliation": "N",
            "endpointDescription": "Business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16661 Ventura Blvd Ste 226",
            "city": "Encino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914361947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Facial Plastic Surgery Physician in Encino, CA
• Providers in Encino, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.