Individual provider Active NPI

Jahanbakhsh Nouri, M.D

  • General Practice Physician
  • Arleta, CA
National Provider Identifier
1366501629
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A53484 Issued in CA
Practice address
8725 Woodman Ave
Arleta, CA 91331-6560
Phone
(818) 891-4455
Fax
(818) 891-5583
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A53484 CA Primary

Addresses

Primary practice location

8725 Woodman Ave
Arleta, CA 91331-6560

Mailing address

8725 Woodman Ave
Arleta, CA 91331
Phone (818) 891-4455

Other identifiers 1

IdentifierTypeStateIssuer
00A534841MedicaidCA

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
I20120221000266 CA Practitioner - General Practice 6305004474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
J and M Laurel Medical Center IncGroup PAC ID 5395155253, 2 clinicians

Practice addresses (Care Compare)

13680 Van Nuys Blvd
Pacoima, CA 91331-3616
Phone (818) 897-7730

8725 Woodman Ave
Arleta, CA 91331-6560
Phone (818) 891-4455

Hospital & facility affiliations

  • Bright Future Home Health, Inc Home health agency, Woodland Hills, CA, CCN 559630

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53484CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodman Medical & Dental Care Inc Legal Medicine CurrentSince May 23, 1997 Accepting new patients
J & M Laurel Medical Center Inc General Practice CurrentSince Sep 23, 2020 Accepting new patients

Locations

8725 Woodman Ave
Arleta, CA 91331
Phone (818) 891-4455

13680 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 265-9499

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: doctornouri@woodmanmedical.officeally.direct

Organizations & group practices 2

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1366501629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "91331",
            "telephone_number": "818-891-4455",
            "fax_number": "818-891-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316560",
            "telephone_number": "818-891-4455",
            "fax_number": "818-891-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURI",
        "first_name": "JAHANBAKHSH",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A53484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534841",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arleta, CA

Sources for this page

Verify at the official NPI Registry.