Individual provider Active NPI

Robert Babak Moghimi, M.D.

  • Gastroenterology Physician
  • Simi Valley, CA
National Provider Identifier
1184679664
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A94790 Issued in CA
Practice address
1156 Swallow LN
Simi Valley, CA 93065-3154
Phone
(805) 526-6016
Fax
(805) 791-3992
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A94790 CA Primary

Addresses

Primary practice location

1156 Swallow LN
Simi Valley, CA 93065-3154

Mailing address

1156 Swallow LN
Simi Valley, CA 93065-3154
Phone (805) 526-6016

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
I20060913000654 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 3779587282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Valley G.I. ConsultantsGroup PAC ID 7719049873, 2 clinicians

Practice addresses (Care Compare)

1156 Swallow LN
Simi Valley, CA 93065-3154
Phone (805) 526-6016

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy360
Upper gastrointestinal (GI) endoscopy for acid reflux598

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94790CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Valley G.I. Consultants Gastroenterology CurrentSince Oct 1, 2008 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Mahendra N. Patel, M.D., Inc. Gastroenterology Past Accepting new patients

Locations

10515 Balboa Blvd
Ste 380
Granada Hills, CA 91344
Phone (818) 363-7120

1156 Swallow Ln
Simi Valley, CA 93065
Phone (805) 526-6016

23823 Valencia Blvd
Ste 210
Valencia, CA 91355
Phone (661) 222-7333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 5

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1184679664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 SWALLOW LN",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653154",
            "telephone_number": "805-526-6016",
            "fax_number": "805-791-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 SWALLOW LN",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653154",
            "telephone_number": "805-526-6016",
            "fax_number": "805-791-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHIMI",
        "first_name": "ROBERT",
        "middle_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A94790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.