Individual provider Active NPI

Amin Sanei Moghaddam, M.D., MPH

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1467808014
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A167227 Issued in CA
Practice address
1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315
Phone
(323) 442-5710
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A167227 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 3000
Los Angeles, CA 90033-5315

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5710

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amin.saneimoghaddam@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC
Direct Messaging Address amoghaddam61844@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MI, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200520000394 CA Practitioner - Neurology 8628363462 Reassigns benefits to 1 organization
I20210805001332 MI Practitioner - Neurology 8628363462 Reassigns benefits to 1 organization
I20241212000794 OH Practitioner - Neurology 8628363462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2130 W Central Ave
101 102 103
Toledo, OH 43606-3834
Phone (419) 291-3900

777 Kimole LN
Suite 250
Adrian, MI 49221-1400
Phone (419) 291-3900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167227CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc General Practice CurrentSince Jun 1, 2020 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Promedica Multi Specialty Physicians Neurology CurrentSince Jan 1, 2026 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 3000
Los Angeles, CA 90033
Phone (323) 442-5728

1520 San Pablo St
Ste 3800
Los Angeles, CA 90033
Phone (323) 442-5720

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

777 Kimole Ln
Ste 130
Adrian, MI 49221
Phone (517) 265-0292

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2130 W Central Ave
Ste 101
Toledo, OH 43606

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2130 W Central Ave
Ste 102
Toledo, OH 43606

Interoperability endpoints

  • Direct secure messaging: amin.saneimoghaddam@direct.usc.edu

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 7

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1467808014",
    "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": "323-442-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 3000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335315",
            "telephone_number": "323-442-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANEI MOGHADDAM",
        "first_name": "AMIN",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-11-03",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A167227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amin.saneimoghaddam@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 3000",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amoghaddam61844@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.