Individual provider Active NPI

Mehdi Farshad Derambakhsh, M.D.

  • MOHS-Micrographic Surgery Physician
  • Encino, CA
National Provider Identifier
1477503563
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
A88950 Issued in CA
Practice address
16260 Ventura Blvd
140
Encino, CA 91436-2203
Phone
(818) 528-2500
Fax
(818) 528-2505
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A88950 CA
MOHS-Micrographic Surgery Physician 207ND0101X A88950 CA Primary
Family Medicine Physician 207Q00000X A88950 CA

Addresses

Primary practice location

16260 Ventura Blvd
140
Encino, CA 91436-2203

Mailing address

210 S Prospect Ave
#4
Redondo Beach, CA 90277-6802
Phone (310) 218-6415

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
I20060619000322 CA Practitioner - DermatologyPractitioner - Family Practice 3870505621 Practice locations: Fountain Valley, CA; Lake Elsinore, CA; Newport Beach, CA; Reseda, CA

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18855 Victory Blvd
Reseda, CA 91335-6445
Phone (818) 774-3216

7150 Tampa Ave
Reseda, CA 91335-3700
Phone (818) 774-3216

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1045
Removal or shaving of skin growth1-10
Skin biopsy75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88950CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mehdi F Derambkhsh MD Inc Dermatology Past Accepting new patients
Shifa Regenerative Center and Pain Management PastSince Sep 3, 2025 Accepting new patients
Ali Roham, DO Inc PastSince Nov 1, 2019 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477503563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S PROSPECT AVE",
            "address_2": "#4",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776802",
            "telephone_number": "310-218-6415",
            "fax_number": "818-528-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "address_2": "140",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362203",
            "telephone_number": "818-528-2500",
            "fax_number": "818-528-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAMBAKHSH",
        "first_name": "MEHDI",
        "middle_name": "FARSHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A88950",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A88950",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.