Individual provider Active NPI

Kian Behmanesh, DO

  • Family Medicine Physician
  • Reseda, CA
National Provider Identifier
1396330676
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A22398 Issued in CA
Practice address
18564 Willard St
Reseda, CA 91335-1253
Phone
(818) 825-7017
NPI assigned
Mar 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A22398 CA Primary

Addresses

Primary practice location

18564 Willard St
Reseda, CA 91335-1253

Mailing address

18564 Willard St
Reseda, CA 91335-1253
Phone (818) 825-7017

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
I20240917001100 CA Practitioner - Family Practice 2163864356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

26357 McBean Pkwy
Valencia, CA 91355-4488
Phone (661) 222-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22398CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients
Providence Facey Medical Foundation Family Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

503 S Buena Vista St
Ste 101
Burbank, CA 91505
Phone (818) 869-7630

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

26357 McBean Pkwy
Valencia, CA 91355
Phone (661) 222-2600

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1396330676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18564 WILLARD ST",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913351253",
            "telephone_number": "818-825-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18564 WILLARD ST",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913351253",
            "telephone_number": "818-825-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHMANESH",
        "first_name": "KIAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.