Individual provider Active NPI

Homayoun Nassiri, M.D.

  • Emergency Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1285747584
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A33224 Issued in CA
Practice address
15107 Vanowen St
Van Nuys, CA 91405-4542
Phone
(818) 902-2990
Fax
(818) 904-3793
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A33224 CA Primary

Addresses

Primary practice location

15107 Vanowen St
Van Nuys, CA 91405-4542

Mailing address

PO Box 662154
Arcadia, CA 91066-2154
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00A332240MedicaidCA

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
I20040927000726 CA Practitioner - Emergency Medicine 7113996281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mend Health IncGroup PAC ID 6406160803, 14 clinicians

Practice addresses (Care Compare)

4312 Woodman Ave
Suite 102
Sherman Oaks, CA 91423-5523
Phone (818) 646-2562

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A33224CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mend Health Inc CurrentSince Aug 6, 2017 Accepting new patients
Mend Medical Inc PastSince Nov 5, 2019 Accepting new patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine PastSince Aug 7, 2022 Accepting new patients

Locations

1701 W Verdugo Ave
Burbank, CA 91506
Phone (310) 488-2830

13636 Ventura Blvd
Sherman Oaks, CA 91423
Phone (818) 763-9997

4312 Woodman Ave
Ste 102
Sherman Oaks, CA 91423
Phone (818) 205-9366

4849 Van Nuys Blvd
Ste 100
Sherman Oaks, CA 91403
Phone (818) 646-4928

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25159/brand/1/csg/1/fhir/r4
  • Direct secure messaging: homayoun.nassiri.1@25159.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1285747584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662154",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910662154",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-902-2990",
            "fax_number": "818-904-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSIRI",
        "first_name": "HOMAYOUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A33224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A332240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.