Individual provider Active NPI

Moeiz Khankhanian, M.D.

  • Psychiatry Physician
  • West Covina, CA
National Provider Identifier
1255478715
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A41134 Issued in CA
Practice address
933 S Sunset Ave
Suite 105
West Covina, CA 91790-3410
Phone
(626) 813-1222
Fax
(626) 813-1221
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A41134 CA Primary

Addresses

Primary practice location

933 S Sunset Ave
Suite 105
West Covina, CA 91790-3410

Mailing address

933 S Sunset Ave
Suite 105
West Covina, CA 91790-3410
Phone (626) 813-1222

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
I20041005000526 CA Practitioner - Psychiatry 5092774265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moiez Khankhanian, M.D. IncGroup PAC ID 8022205996, 3 clinicians

Practice addresses (Care Compare)

438 W Las Tunas Dr
San Gabriel, CA 91776-1216
Phone (626) 289-5454

7500 Hellman Ave
Rosemead, CA 91770-2216
Phone (626) 813-1222

933 S Sunset Ave
Suite 105
West Covina, CA 91790-3410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as individual
Quality
60
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A41134CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seabreeze Mental Health Inc Psychiatry Current Accepting new patients
Moiez Khankhanian, M.D. Inc Psychiatry CurrentSince Oct 14, 2010 Accepting new patients

Locations

933 S Sunset Ave
Ste 105
West Covina, CA 91790
Phone (626) 813-1222

Organizations & group practices 2

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 3

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255478715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 S SUNSET AVE",
            "address_2": "SUITE 105",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903410",
            "telephone_number": "626-813-1222",
            "fax_number": "626-813-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 S SUNSET AVE",
            "address_2": "SUITE 105",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903410",
            "telephone_number": "626-813-1222",
            "fax_number": "626-813-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANKHANIAN",
        "first_name": "MOEIZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A41134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.