Individual provider Active NPI

Selaiman Noori, MD

  • Pain Medicine (Anesthesiology) Physician
  • Lake Havasu City, AZ
National Provider Identifier
1104244631
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
57811 Issued in AZ
Practice address
25 Riviera Blvd
Lake Havasu City, AZ 86403-5694
Phone
(928) 505-7246
NPI assigned
Apr 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 57.245211 OH
Pain Medicine (Anesthesiology) Physician 207LP2900X 57811 AZ Primary

Addresses

Primary practice location

25 Riviera Blvd
Lake Havasu City, AZ 86403-5694

Mailing address

1750 McCulloch Blvd N # 2548
Lake Havasu City, AZ 86403-6556

Other practice location 1

1791 Mesquite Ave
Lake Havasu City, AZ 86403-5648
Phone (928) 505-7246

Other practice location 2

3003 Highway 95 Ste 63
Bullhead City, AZ 86442-7896
Phone (928) 505-7246

Other practice location 3

5950 S Durango Dr Ste 105
Las Vegas, NV 89113-2270
Phone (702) 932-0606 ext. 212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200220000938 AZ Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 6406114412 Reassigns benefits to 1 organization
I20220610002379 NV Practitioner - Anesthesiology 6406114412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
New York Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Orthopedic Institute LLCGroup PAC ID 1052316445, 13 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

25 Riviera Blvd
Lake Havasu City, AZ 86403-5694
Phone (928) 505-5555

2585 Miracle Mile
Bullhead City, AZ 86442-7522

5950 S Durango Dr
Suite 101
Las Vegas, NV 89113-2270
Phone (702) 462-9820

Hospital & facility affiliations

  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101
  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
68.27
Promoting interoperability
100
Improvement activities
40
Cost
78.59

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Orthopedic Institute LLC Current Accepting new patients
Lakeside Orthopedic Institute LLC CurrentSince Mar 1, 2021 Accepting new patients
Advanced Paincare LLP CurrentSince May 1, 2022 Accepting new patients
Lakeside Orthopedic Institute LLC CurrentSince Jun 19, 2023 Accepting new patients
Lakeside Orthopedic Institute LLC CurrentSince Mar 1, 2021 Accepting new patients
Lakeside Orthopedic Institute, LLC Past Accepting new patients
Lakeside Orthopedic Institute LLC Past Accepting new patients
Vip Surg (Tsuda Ryan), PLLC Past Accepting new patients

Locations

2440 Adobe Rd
Ste 101
Bullhead City, AZ 86442
Phone (928) 763-3181

3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555

1791 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 855-1444

25 Riviera Blvd
Lk Havasu Cty, AZ 86403
Phone (928) 505-7246

1720 Mesquite Ave
Ste 100
Lk Havasu Cty, AZ 86403
Phone (928) 855-1550

1944 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 505-9729

2505 Anthem Village Dr
#E625
Henderson, NV 89052

2865 Siena Heights Dr
Ste 120
Henderson, NV 89052
Phone (702) 932-0606

5950 S Durango Dr
Ste 101
Las Vegas, NV 89113
Phone (702) 462-9820

5950 S Durango Dr
Ste 105
Las Vegas, NV 89113
Phone (702) 487-6000

Interoperability endpoints

  • Direct secure messaging: ndi5449@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HDEDDD/Endpoint/HDEDDD

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1104244631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 MCCULLOCH BLVD N # 2548",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 RIVIERA BLVD",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035694",
            "telephone_number": "928-505-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1791 Mesquite Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035648",
            "country_code": "US",
            "telephone_number": "928-505-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3003 Highway 95 Ste 63",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864427896",
            "country_code": "US",
            "telephone_number": "928-505-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5950 S Durango Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891132270",
            "country_code": "US",
            "telephone_number": "702-932-0606 x212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOORI",
        "first_name": "SELAIMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "57.245211",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "57811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.