Individual provider Active NPI

Amin Anton Abdi, MD

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1437438009
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A117660 Issued in CA
Practice address
1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone
(818) 790-7100
NPI assigned
Aug 12, 2011
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A117660 CA Primary

Addresses

Primary practice location

1812 Verdugo Blvd
Glendale, CA 91208-1407

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (818) 790-7100

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20131029000107 CA Practitioner - Emergency Medicine 3971738949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Viejo Emergency Medical AssociatesGroup PAC ID 2163335241, 17 clinicians
Mission Viejo Emergency Medical Associates, Inc.Group PAC ID 7315090271, 28 clinicians

Practice addresses (Care Compare)

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 365-2202

31872 Coast Hwy
Laguna Beach, CA 92651-6773
Phone (949) 499-7193

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117660CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Park Emergency Physicians, Inc Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Mission Viejo Emergency Medical Associates Emergency Medicine CurrentSince Dec 1, 2015 Accepting new patients
Mission Viejo Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Sep 10, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2013 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2013 Accepting new patients

Locations

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

2623 E Slauson Ave
Walnut Park, CA 90255
Phone (323) 277-5855

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1437438009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "818-790-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 VERDUGO BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081407",
            "telephone_number": "818-790-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDI",
        "first_name": "AMIN",
        "middle_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A117660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.