Jennifer Ahdout, M.D.
Individual provider Active NPI Dermatology Physician · Beverly Hills, CA
NPI 1356571897 · NPPES record last updated Mar 22, 2017
Key facts
- NPI
- 1356571897
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 115046 (CA)
- Practice address
- 450 N Roxbury Dr
Ste 400
Beverly Hills, CA 90210-4218 - Phone
- (424) 394-1610
- Fax
- (424) 394-1628
- NPI assigned
- Jul 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of California, San Diego School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Roxbury Dermatology and Multispecialty Practice Inc
Practice addresses (Care Compare)
662 N Sepulveda
Suite 300
Los Angeles, CA 90049-2108
662 N Sepulveda Blvd
Suite 300
Los Angeles, CA 90049-2108
Phone (909) 574-4686
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 428 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 144 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140227000079 | CA | Practitioner - Dermatology | 4183854771 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115046 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer Ahdout MD, Inc. | Dermatology | Current | Accepting new patients |
| Roxbury Dermatology and Multispecialty Practice Inc | Dermatology | Current |
Accepting new patients |
| Cedars-Sinai Medical Center | Past | Accepting new patients |
Locations
450 N Roxbury Dr
Ste 400
Beverly Hills, CA 90210
Phone (310) 614-5898
450 N Roxbury Dr
Ste 410
Beverly Hills, CA 90210
Phone (844) 544-1617
2934 N Beverly Glen Cir
Ste 716
Los Angeles, CA 90077
662 N Sepulveda Blvd
Ste 300
Los Angeles, CA 90049
Phone (909) 574-4686
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 115046 | CA | Yes |
Addresses
Primary practice location
450 N Roxbury Dr
Ste 400
Beverly Hills, CA 90210-4218
Mailing address
450 N Roxbury Dr
Ste 400
Beverly Hills, CA 90210-4218
Phone (424) 394-1610
Other providers in Beverly Hills, CA
- Rhebe Rosalind Aguado
- Gal Aharonov
- Emilia Ahdoot
- Patricia Ahdoot
- Tanya Ahdoot
- Ahm Medical Corporation
- Maryam Ahmadian
- Alexander Ahn
- Daniel Sung Jun Ahn
- Stacey Jeemin Ahn
All providers in Beverly Hills, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.