Individual provider Active NPI

Reza Alizadeh, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Santa Monica, CA
National Provider Identifier
1205360484
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
A178828 Issued in CA
Practice address
1807 Wilshire Blvd Ste 203
Santa Monica, CA 90403-5790
Phone
(310) 829-0160
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X A178828 CA Primary

Addresses

Primary practice location

1807 Wilshire Blvd Ste 203
Santa Monica, CA 90403-5790

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

100 Stein Plz Ste 2-273
Los Angeles, CA 90095-3153
Phone (310) 794-9442

Other identifiers 1

IdentifierTypeStateIssuer
0441846MedicaidOH

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
I20220824000951 CA Practitioner - Ophthalmology 8820352305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jules Stein Eye Institute Medical GroupGroup PAC ID 5597663740, 118 clinicians

Practice addresses (Care Compare)

1807 Wilshire Blvd
Suite 203
Santa Monica, CA 90403-5790
Phone (310) 829-0160

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A178828CAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group Ophthalmology CurrentSince Apr 1, 2024 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
UCLA Medical Group Ophthalmology Past Accepting new patients
Oklahoma State University Medical Trust Ophthalmology Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

18111 Brookhurst St
Ste 6400
Fountain Vly, CA 92708
Phone (714) 350-7258

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

100 Stein Plz
Ste 2273
Los Angeles, CA 90095
Phone (310) 794-9442

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

1807 Wilshire Blvd
Ste 203
Santa Monica, CA 90403
Phone (310) 564-6507

Interoperability endpoints

  • Direct secure messaging: ralizadeh392010@direct.uclahealth.org

Organizations & group practices 6

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 2

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1205360484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 WILSHIRE BLVD STE 203",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035790",
            "telephone_number": "310-829-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Stein Plz Ste 2-273",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953153",
            "country_code": "US",
            "telephone_number": "310-794-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALIZADEH",
        "first_name": "REZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "CA",
            "license": "A178828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0441846",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.