Individual provider Active NPI

Soheil Daniel Gideon

  • Hospitalist Physician
  • Valley Village, CA
National Provider Identifier
1144780719
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A184590 Issued in CA
Practice address
12629 Riverside Dr Apt 337
Valley Village, CA 91607-3490
Phone
(818) 625-9439
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A184590 CA
Hospitalist Physician 208M00000X A184590 CA Primary

Addresses

Primary practice location

12629 Riverside Dr Apt 337
Valley Village, CA 91607-3490

Mailing address

12629 Riverside Dr Apt 337
Valley Village, CA 91607-3490
Phone (818) 625-9439

Other practice location 1

18321 Clark St
Tarzana, CA 91356-3501
Phone (310) 423-5252

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230602000307 CA Practitioner - HospitalistPractitioner - Internal Medicine 1355708538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

18321 Clark St
Tarzana, CA 91356-3501
Phone (818) 881-0800

Hospital & facility affiliations

  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 1, 2024 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 1, 2024 Accepting new patients
Fountain Valley Group Services PC Hospitalist CurrentSince Apr 15, 2023 Accepting new patients
Fountain Valley Group Services PC Past Accepting new patients

Locations

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1144780719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12629 RIVERSIDE DR APT 337",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073490",
            "telephone_number": "818-625-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12629 RIVERSIDE DR APT 337",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073490",
            "telephone_number": "818-625-9439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18321 Clark St",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913563501",
            "country_code": "US",
            "telephone_number": "310-423-5252",
            "fax_number": "310-423-8441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIDEON",
        "first_name": "SOHEIL",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A184590",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A184590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

Verify at the official NPI Registry.