NPIMap

Individual provider Active NPI

Amirhassan Bahreman, M.D.

  • Neurology Physician
  • La Mesa, CA
National Provider Identifier
1164426953
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01059340A Issued in IN
Practice address
8851 Center Dr
Suite 608
La Mesa, CA 91942-3017
Phone
(619) 460-5850
Fax
(619) 460-5849
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01059340A IN Primary

Addresses

Primary practice location

8851 Center Dr
Suite 608
La Mesa, CA 91942-3017

Mailing address

8851 Center Dr
Suite 608
La Mesa, CA 91942-3017
Phone (619) 460-5850

Other identifiers 1

IdentifierTypeStateIssuer
200498540MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080716000275 CA Practitioner - Neurology 9133188295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8851 Ctr Dr
Suite 608
La Mesa, CA 91942-3199
Phone (619) 460-5850

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01059340AINMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 1, 2014 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
California Specialty Medical Group Past Accepting new patients
Foygelman Podiatric Corporation Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 4

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1164426953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR",
            "address_2": "SUITE 608",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423017",
            "telephone_number": "619-460-5850",
            "fax_number": "619-460-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR",
            "address_2": "SUITE 608",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423017",
            "telephone_number": "619-460-5850",
            "fax_number": "619-460-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHREMAN",
        "first_name": "AMIRHASSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01059340A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200498540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.