NPIMap

Individual provider Active NPI

Marjan Chegounchi, MD

  • Internal Medicine Physician
  • Inglewood, CA
National Provider Identifier
1285660456
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A80479 Issued in CA
Practice address
501 E Hardy St
Ste 205
Inglewood, CA 90301-4054
Phone
(310) 671-6364
Fax
(310) 671-8184
NPI assigned
Jun 23, 2006
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A80479 CA Primary
Nephrology Physician 207RN0300X A80479 CA

Addresses

Primary practice location

501 E Hardy St
Ste 205
Inglewood, CA 90301-4054

Mailing address

PO Box 390005
San Diego, CA 92149-0005
Phone (619) 746-6530

Other practice location 1

11860 Wilshire Blvd Ste 100
Los Angeles, CA 90025-6606
Phone (310) 412-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050712000681 CA Practitioner - Internal MedicinePractitioner - Nephrology 3375579246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Centinela Hospitalist Medical Group IncGroup PAC ID 3274696810, 11 clinicians

Practice addresses (Care Compare)

501 E Hardy St
Suite 408
Inglewood, CA 90301-4065
Phone (310) 671-7888

555 E Hardy St
Inglewood, CA 90301-4011
Phone (310) 673-4660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A80479CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marjan Chegounchi MD Inc Nephrology CurrentSince Jul 1, 2008 Accepting new patients
Centinela Hospitalist Medical Group Inc Internal Medicine CurrentSince Apr 14, 2009 Accepting new patients
Angel Kidney Care of Inglewood Inc Past Accepting new patients
Friends & Family Medical Clinic, Inc. PastSince Aug 21, 2006 Accepting new patients

Locations

501 E Hardy St
Ste 205
Inglewood, CA 90301
Phone (310) 671-6364

501 E Hardy St
Ste 408
Inglewood, CA 90301
Phone (310) 671-6364

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1285660456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390005",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921490005",
            "telephone_number": "619-746-6530",
            "fax_number": "619-746-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST",
            "address_2": "STE 205",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014054",
            "telephone_number": "310-671-6364",
            "fax_number": "310-671-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11860 Wilshire Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900256606",
            "country_code": "US",
            "telephone_number": "310-412-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEGOUNCHI",
        "first_name": "MARJAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80479",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A80479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.