Individual provider Active NPI

Omid Adibnazari, M.D.

  • Emergency Medicine Physician
  • Torrance, CA
National Provider Identifier
1134573124
Registry record updated Apr 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A151524 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(310) 222-2345
NPI assigned
Apr 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A151524 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

1000 W Carson St
Torrance, CA 90502-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 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
I20191125002217 CA Practitioner - Emergency Medicine 4688007099 Reassigns benefits to 1 organization
I20240807000022 TX Practitioner - Emergency Medicine 4688007099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS IHS Phoenix AreaGroup PAC ID 0244405629, 54 clinicians

Practice addresses (Care Compare)

12033 Agency Rd
Parker, AZ 85344-7718
Phone (928) 669-2137

Hospital & facility affiliations

  • Parker Indian Health Center Hospital, Parker, AZ, CCN 031307

Merit-based Incentive Payment System (MIPS)

Final score
70.2 of 100Reported as group
Quality
74.9
Improvement activities
40
Cost
20.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151524CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area Current Accepting new patients
Coast Plaza Emergency Physicians Group Inc Emergency Medicine CurrentSince Aug 31, 2019 Accepting new patients
DHHS IHS Phoenix CurrentSince May 25, 2024 Accepting new patients
DHHS IHS Phoenix Area CurrentSince May 25, 2024 Accepting new patients
DHHS IHS Phoenix Area Current Accepting new patients

Locations

12033 Agency Rd
Parker, AZ 85344
Phone (760) 572-4137

13100 Studebaker Rd
Norwalk, CA 90650
Phone (562) 420-1945

Organizations & group practices 5

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 1

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": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556409600000",
    "number": "1134573124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADIBNAZARI",
        "first_name": "OMID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-16",
        "last_updated": "2019-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A151524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.