Individual provider Active NPI

Simona Davoudpour, D.O.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1265688311
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A10113 Issued in CA
Practice address
8635 W 3Rd St
Los Angeles, CA 90048-6101
Phone
(310) 385-3518
NPI assigned
Aug 8, 2008
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A10113 CA Primary

Addresses

Primary practice location

8635 W 3Rd St
Los Angeles, CA 90048-6101

Mailing address

9001 Wilshire Blvd
Ste 306
Beverly Hills, CA 90211-1841
Phone (818) 265-2264

Other practice location 1

801 S Chevy Chase Dr
#250
Glendale, CA 91205-4431
Phone (818) 265-2264

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
I20100107000565 CA Practitioner - Family Practice 9830230259 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10113CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Hills Concierge Doctor, Inc CurrentSince May 19, 2021 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2023 Accepting new patients
Arash Bereliani, M.D., a Medical Corporation CurrentSince Jan 7, 2020 Accepting new patients

Locations

125 N Robertson Blvd
Beverly Hills, CA 90211
Phone (310) 550-8000

9400 Brighton Way
Ste 303
Beverly Hills, CA 90210
Phone (310) 499-8116

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

Interoperability endpoints

  • Direct secure messaging: sdavoudpour436833@direct.cshs.org
  • Direct secure messaging: sdavoudpour752907@direct.uclahealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1265688311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 WILSHIRE BLVD",
            "address_2": "STE 306",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111841",
            "telephone_number": "818-265-2264",
            "fax_number": "818-265-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-385-3518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Chevy Chase Dr",
            "address_2": "#250",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912054431",
            "country_code": "US",
            "telephone_number": "818-265-2264",
            "fax_number": "818-265-2263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVOUDPOUR",
        "first_name": "SIMONA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.