Seyed Mohammad Reza Khoddami, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A109665 Issued in CA

Practice address

2705 Loma Vista Rd
Suite 206
Ventura, CA 93003-1581

Phone

(805) 643-4067

Fax

(805) 643-4587

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Urology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394
• Community Memorial Hospital - Ojai Hospital, Ojai, CA, CCN 051334
• St Johns Regional Medical Center Hospital, Oxnard, CA, CCN 050082
• Ventura County Medical Center Hospital, Ventura, CA, CCN 050159

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: skhoddami3518425@oc.providencedirect.org
• Direct secure messaging: seyedkhoddami@cfh.allscriptsdirect.net

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.

• Community Memorial Health System

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1215903018
  Medicare reassignment Care Compare group NPD
• Khoddami Medical Group Inc

  • Urology Physician
  • Ventura, CA
  • NPI 1598318461
  NPD Authorized official
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ojai, CA
  • NPI 1588446892
  NPD
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Oxnard, CA
  • NPI 1740228345
  NPD
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Oxnard, CA
  • NPI 1124067574
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Oxnard, CA
  • NPI 1073665360
  NPD (past)
• Paul D Silverman MD

  • Specialist
  • Ventura, CA
  • NPI 1033230388
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ventura, CA
  • NPI 1083001010

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ventura, CA
  • NPI 1114111309

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Community Health Clinic/Center
  • Ojai, CA
  • NPI 1154609436

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1215903018
  Care Compare affiliation
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Oxnard, CA
  • NPI 1497060297

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Gynecologic Oncology Physician
  • Ventura, CA
  • NPI 1619453982

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Port Hueneme, CA
  • NPI 1659656775

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ventura, CA
  • NPI 1700303633

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Orthopaedic Surgery Physician
  • Camarillo, CA
  • NPI 1871919126

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ojai, CA
  • NPI 1942872106

  Hospital

  Care Compare affiliation
• Community Memorial Health System

  • Critical Access Hospital
  • Ojai, CA
  • NPI 1992876767
  Care Compare affiliation
• County of Ventura

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Care Compare affiliation

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1437278603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 LOMA VISTA RD",
            "address_2": "SUITE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031581",
            "telephone_number": "805-643-4067",
            "fax_number": "805-643-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODDAMI",
        "first_name": "SEYED",
        "middle_name": "MOHAMMAD REZA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CA",
            "license": "A109665",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A109665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE",
            "identifier": "A109665",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khazali Dental Corporation
• Khepera House Inc
• Khepera House Inc
• Khepera House Inc
• Khoddami Medical Group Inc
• Mary Georgiana Kiddle, RDN
• Kidney Dialysis Center of Ventura,LLC
• Kelly Marie Kidon, DDS
• Kids & Families Together
• Kids & Families Together

• Urology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.