Saba Sadat Khansari, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60973 Issued in CA

Practice address

1811 N Western Ave
Los Angeles, CA 90027-3403

Phone

(855) 783-2434

NPI assigned

Aug 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: saba.sadat.khansari.1@26356.direct.athenahealth.com

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.

• AIDS Healthcare Foundation

  • Infectious Disease Physician
  • San Francisco, CA
  • NPI 1467078063

  Single Specialty

  Medicare reassignment NPD
• AIDS Healthcare Foundation

  • Community/Retail Pharmacy
  • Baton Rouge, LA
  • NPI 1891525184
  NPD

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1467000802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900273403",
            "telephone_number": "855-783-2434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Clifton Rd NE Ste 280",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221000",
            "country_code": "US",
            "telephone_number": "404-727-6123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADAT KHANSARI",
        "first_name": "SABA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA60973",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sacred Entrance Midwifery Services
• Sacred Fortune
• Sacred Heart Hospice, Inc.
• Sacred One Hospice, Inc.
• Avishai Sadan, DMD
• Mamatha R Sadda, M.D.
• Nariman Saddad
• Louis Alexander Saddic III, M.D. PH.D.
• Hoda Sadeghi Hadad Zavareh
• Tahereh Sadeghi Sina

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.