Individual provider Active NPI

Sepehr Hamidi, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1124386032
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
A133336 Issued in CA
Practice address
10833 Le Conte Ave # 255-C
Los Angeles, CA 90095
Phone
(310) 267-3561
Fax
(310) 267-2058
NPI assigned
Apr 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X A133336 CA
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X A133336 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave # 255-C
Los Angeles, CA 90095

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

801 Broadway N
Fargo, ND 58102
Phone (701) 234-2000

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
I20190711001262 CA Practitioner - Pathology 0042563041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2003
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)

1000 Veteran Ave
Los Angeles, CA 90024-2704

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

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Merit-based Incentive Payment System (MIPS)

Final score
92.23 of 100Reported as group
Quality
79.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133336CAMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Pathology and Laboratory Medicine Group CurrentSince Sep 1, 2019 Accepting new patients

Locations

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

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

10833 Le Conte Ave
#255C
Los Angeles, CA 90095
Phone (310) 267-3561

File 55632
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: shamidi730957@direct.uclahealth.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.

Hospital & facility affiliations 2

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1124386032",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE # 255-C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-267-3561",
            "fax_number": "310-267-2058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Broadway N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "58102",
            "country_code": "US",
            "telephone_number": "701-234-2000",
            "fax_number": "701-234-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMIDI",
        "first_name": "SEPEHR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A133336",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "A133336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.