Active NPI
Roger J. Mah, M.D.
- Anesthesiology Physician
- Santa Monica, CA
National Provider Identifier
1477564185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G77107
- Practice address
- 1328 22ND St
Santa Monica, CA 90404-2032 - Phone
- (310) 829-8202
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G77107 | CA | Primary |
Addresses
Primary practice location
1328 22ND St
Santa Monica, CA 90404-2032
Mailing address
11999 San Vicente Blvd
#440
Los Angeles, CA 90049-5131
Phone (310) 471-5852
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Medical College of Pennsylvania, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12400 Wilshire Blvd
Suite 100
Los Angeles, CA 90025-1067
Phone (310) 442-5566
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G77107 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roger Joseph Mah Corporation | Anesthesiology | Current | Accepting new patients |
| Bayside Anesthesia Medical Group | Current | Accepting new patients |
Locations
12400 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 422-5566
1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Santa Monica, CA
- NPI 1003259060
-
- Pain Medicine (Anesthesiology) Physician
- Santa Monica, CA
- NPI 1184668469
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477564185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11999 SAN VICENTE BLVD",
"address_2": "#440",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495131",
"telephone_number": "310-471-5852",
"fax_number": "310-471-3958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1328 22ND ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042032",
"telephone_number": "310-829-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAH",
"first_name": "ROGER",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G77107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
- Emily Magid, IBCLC, MPH, MSW
- Valerie Magill, NPC
- Steven Paul Magit, MA MFC
- Kathy Elizabeth Magliato, MD
- Marguerite Maguire, M.D.
- Walcharee Cindy Mahamitra, D.O.
- Michelle Mahanian Oheb, M.D.
- Mahasty Mahooty Rdhap Healthy Smiles of California Dental Hygiene, Inc
- Omeed Mahboobian, D.D.S.
- Mehrnaz Mahdad, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.