Individual provider Active NPI

Mai Elzieny, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1104499342
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4351047658 Issued in MI
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-6712
Phone
(310) 206-0944
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4351047658 MI Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-6712

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

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
I20250530001915 CA Practitioner - Pathology 4284037367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCLA Pathology and Laboratory Medicine GroupGroup PAC ID 5597679233, 68 clinicians

Practice addresses (Care Compare)

10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone (310) 267-2625

5900 W Olympia Blvd
Los Angeles, CA 90036-4671
Phone (310) 267-2680

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351047658MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Pathology and Laboratory Medicine Group Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2025 Accepting new patients

Locations

10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932

File 55632
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

5900 W Olympic Blvd
Los Angeles, CA 90036
Phone (310) 267-2680

Interoperability endpoints

  • Direct secure messaging: melzieny1232668@epic00.shdirect.org

Organizations & group practices 1

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": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1104499342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956712",
            "telephone_number": "310-206-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELZIENY",
        "first_name": "MAI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2025-07-08",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4351047658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.