Individual provider Active NPI

Amir Homayon Raeesy-Nezhad, MD

  • Internal Medicine Physician
  • Encino, CA
National Provider Identifier
1417044132
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A97308 Issued in CA
Practice address
16311 Ventura Blvd Ste 955
Encino, CA 91436-4339
Phone
(818) 701-0017
Fax
(818) 817-5541
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36003 AZ
Internal Medicine Physician 207R00000X A97308 CA Primary

Addresses

Primary practice location

16311 Ventura Blvd Ste 955
Encino, CA 91436-4339

Mailing address

16311 Ventura Blvd Ste 955
Encino, CA 91436-4339
Phone (818) 701-0017

Other identifiers 1

IdentifierTypeStateIssuer
A97308OtherCAMEDICAL LICENSE

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
I20070118000604 CA Practitioner - Internal MedicinePractitioner - Family Practice 8022019991 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97308CAMDClinical Social Worker
36003AZMDInternal Medicine Physician
A97308CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince May 5, 2008 Accepting new patients
County of Los Angeles CurrentSince May 5, 2008 Accepting new patients
Valley Integrated Health Care Service Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

7601 Imperial Hwy
Downey, CA 90242
Phone (310) 940-8111

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1417044132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 955",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364339",
            "telephone_number": "818-701-0017",
            "fax_number": "818-817-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 955",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364339",
            "telephone_number": "818-701-0017",
            "fax_number": "818-817-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAEESY-NEZHAD",
        "first_name": "AMIR",
        "middle_name": "HOMAYON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "36003",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A97308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A97308",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.