Active NPI
Masoom Modi, M.D.
- Rheumatology Physician
- Los Angeles, CA
National Provider Identifier
1326377029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- A118117
- Practice address
- 1000 Veteran Ave
Los Angeles, CA 90024-2704 - Phone
- (310) 825-2572
- NPI assigned
- Dec 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R71459 | AZ | |
| Internal Medicine Physician | 207R00000X | A118117 | CA | |
| Rheumatology Physician | 207RR0500X | A118117 | CA | Primary |
Addresses
Primary practice location
1000 Veteran Ave
Los Angeles, CA 90024-2704
Mailing address
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R71459 | AZ | MD | Internal Medicine Physician |
| A118117 | CA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1326377029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 VETERAN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900242704",
"telephone_number": "310-825-2572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODI",
"first_name": "MASOOM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-09",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "R71459",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A118117",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "A118117",
"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 Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.