Individual provider Active NPI

Nazanin Sanaei, MD

  • Pediatrics Physician
  • Santa Ana, CA
National Provider Identifier
1477737161
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A107153 Issued in CA
Practice address
1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641
Phone
(714) 352-2911
Fax
(714) 352-2903
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A107153 CA Primary

Addresses

Primary practice location

1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641

Mailing address

1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641
Phone (714) 352-2911

Other identifiers 1

IdentifierTypeStateIssuer
00A1071530MedicaidCA

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
I20091028000463 CA Practitioner - Pediatric Medicine 4183761810 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107153CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Serve the People, Inc CurrentSince Jan 7, 2025 Accepting new patients

Locations

1206 E 17th St
Ste 101
Santa Ana, CA 92701
Phone (714) 352-2911

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1477737161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911",
            "fax_number": "714-352-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911",
            "fax_number": "714-352-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANAEI",
        "first_name": "NAZANIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A107153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1071530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.