Individual provider Active NPI

Moussa Moshfegh, M.D.

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1326247404
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A38055 Issued in CA
Practice address
6221 Wilshire Blvd
Suite 404
Los Angeles, CA 90048-5201
Phone
(323) 933-3810
Fax
(323) 933-7522
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A38055 CA Primary

Addresses

Primary practice location

6221 Wilshire Blvd
Suite 404
Los Angeles, CA 90048-5201

Mailing address

6221 Wilshire Blvd
Suite 404
Los Angeles, CA 90048-5201
Phone (323) 933-3810

Other identifiers 1

IdentifierTypeStateIssuer
00A380550MedicaidCA

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
I20101029001061 CA Practitioner - General Surgery 9830383256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6221 Wilshire Blvd
Suite 404
Los Angeles, CA 90048-5224
Phone (323) 933-3810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38055CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moussa Moshfegh MD, Inc Specialist CurrentSince Jun 26, 2001 Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Bakersfield Emergency Medical Corp. Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients

Locations

6221 Wilshire Blvd
Ste 404
Los Angeles, CA 90048
Phone (323) 933-3810

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 1

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1326247404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-933-3810",
            "fax_number": "323-933-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 WILSHIRE BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485201",
            "telephone_number": "323-933-3810",
            "fax_number": "323-933-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHFEGH",
        "first_name": "MOUSSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A38055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A380550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.