Individual provider Active NPI

Payam Benjamin Nikravesh, DPM

  • Foot & Ankle Surgery Podiatrist
  • Los Angeles, CA
National Provider Identifier
1437192200
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4103 Issued in CA
Practice address
6404 Wilshire Blvd
Suite 600
Los Angeles, CA 90048-5501
Phone
(323) 782-8586
Fax
(323) 782-8528
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4103 CA Primary

Addresses

Primary practice location

6404 Wilshire Blvd
Suite 600
Los Angeles, CA 90048-5501

Mailing address

6404 Wilshire Blvd
Suite 600
Los Angeles, CA 90048-5501
Phone (323) 782-8586

Other identifiers 1

IdentifierTypeStateIssuer
000E41032MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000773 CA Practitioner - Podiatry 8022001783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6404 Wilshire Blvd
Suite 600
Los Angeles, CA 90048-5508
Phone (818) 609-1995

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue80
Removal of skin lesions1-10
Removal of nail tissue708
Removal or shaving of skin growth213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4103CAMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
P.B. Nikravesh DPM, Apc Foot & Ankle Surgery CurrentSince Dec 15, 1997 Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Dr Niks Foot and Ankle Center Inc Foot & Ankle Surgery Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

6404 Wilshire Blvd
Ste 600
Los Angeles, CA 90048
Phone (310) 659-2226

Organizations & group practices 6

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 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1437192200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485501",
            "telephone_number": "323-782-8586",
            "fax_number": "323-782-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD",
            "address_2": "SUITE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485501",
            "telephone_number": "323-782-8586",
            "fax_number": "323-782-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKRAVESH",
        "first_name": "PAYAM",
        "middle_name": "BENJAMIN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E41032",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.