Ata Mazaheri, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A79930 Issued in CA

Practice address

1560 E Chevy Chase Dr
Suite 450
Glendale, CA 91206-4197

Phone

(818) 246-3300

Fax

(818) 247-7600

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

General Surgery

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amazaheri405246@oc.providencedirect.org

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.

• Ata Mazaheri MD Inc.

  • Surgery Physician
  • Glendale, CA
  • NPI 1134430606
  Medicare reassignment NPD Authorized official
• Southern California Hospitalist Network Medical Group Inc

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1790880458
  NPD (past)
• Usc Surgeons, Inc.

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1821034315
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System Southern California

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1164467239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 EARL ST",
            "address_2": "STE 245",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034355",
            "telephone_number": "818-247-7600",
            "fax_number": "818-247-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E CHEVY CHASE DR",
            "address_2": "SUITE 450",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064197",
            "telephone_number": "818-246-3300",
            "fax_number": "818-247-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZAHERI",
        "first_name": "ATA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A79930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A799300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Gail Maxson, PH.D., PSY.D
• Margaret Evelyn May
• Maya Home Health Services Inc
• Mayerling Home Health LLC
• Mayerling Pharmacy, Inc
• Lauren Mazahery, MSW
• Scally Yulisa Mazariegos, NONE
• Manvel Michael Mazmanyan, M.D.
• Meline Mazmanyan, PHD
• Vanya Mazmanyan

• Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.