Individual provider Active NPI

Pejman Samouha, M.D

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1437397205
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1435 S Vermont Ave Ste 100
Los Angeles, CA 90006-4543
Phone
(213) 386-2511
NPI assigned
Feb 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X
Specialist 174400000X Primary

Addresses

Primary practice location

1435 S Vermont Ave Ste 100
Los Angeles, CA 90006-4543

Mailing address

1435 S Vermont Ave Ste 100
Los Angeles, CA 90006-4543

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
I20090728000211 CA Practitioner - General Practice 9436202298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1435 S Vermont Ave
Suite 100
Los Angeles, CA 90006-4543
Phone (213) 386-2511

Hospital & facility affiliations

  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Spinal fusion1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pejman Samouha M.D. Inc Specialist CurrentSince Apr 3, 2012 Accepting new patients
Hooman M Melamed MD a Prof Corp Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients

Locations

4858 W Pico Blvd
Los Angeles, CA 90019
Phone (323) 332-1079

1435 S Vermont Ave
Ste 100
Los Angeles, CA 90006
Phone (213) 386-2511

Organizations & group practices 4

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": "1233446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1437397205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 S VERMONT AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 S VERMONT AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064543",
            "telephone_number": "213-386-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMOUHA",
        "first_name": "PEJMAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-01",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.