Active NPI
Payam Ebizadeh, MD
- Diagnostic Radiology Physician
- Los Angeles, CA
National Provider Identifier
1306351895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 109881
- Practice address
- 1233 S Westgate Ave Apt 307
Los Angeles, CA 90025-6792 - Phone
- (267) 496-9056
- NPI assigned
- Dec 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A109881 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | 109881 | CA | Primary |
Addresses
Primary practice location
1233 S Westgate Ave Apt 307
Los Angeles, CA 90025-6792
Mailing address
1233 S Westgate Ave Apt 307
Los Angeles, CA 90025-6792
Phone (267) 496-9056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109881 | CA | MD | Mental Health Counselor |
| A109881 | CA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wound Technology Network Inc | Current | Accepting new patients | |
| WT Health of Florida LLC | Current | Accepting new patients |
Locations
5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757635200000",
"number": "1306351895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 S WESTGATE AVE APT 307",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900256792",
"telephone_number": "267-496-9056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 S WESTGATE AVE APT 307",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900256792",
"telephone_number": "267-496-9056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBIZADEH",
"first_name": "PAYAM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-06",
"last_updated": "2025-09-12",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A109881",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "109881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.