Organization Active NPI

MVP Nephrology Dialysis PC

  • Nephrology Physician
  • Sherman Oaks, CA
National Provider Identifier
1497373237
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MVP NEPHROLOGY DIALYSIS PC
Practice address
4911 Van Nuys Blvd
Sherman Oaks, CA 91403-1716
Phone
(818) 981-7111
NPI assigned
Jul 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Nima Rabbani, DONPI 1619179454
Title
Cfo
Phone
(818) 259-4724

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4911 Van Nuys Blvd
Sherman Oaks, CA 91403-1716

Mailing address

501 W Glenoaks Blvd Ste 341
Glendale, CA 91202-2896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200728002571 CA Part B Supplier - Clinic/Group Practice 0749604429 Receives reassigned benefits from 2 practitioners
Practice locations: Encino, CA; Sherman Oaks, CA; Van Nuys, CA

National Provider Directory

National Provider Directory

Locations

501 W Glenoaks Blvd
Ste 341
Glendale, CA 91202

4955 Van Nuys Blvd
Ste 111
Sherman Oaks, CA 91403
Phone (818) 285-5913

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1497373237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD STE 341",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031716",
            "telephone_number": "818-981-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVP NEPHROLOGY DIALYSIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "RABBANI",
        "authorized_official_first_name": "NIMA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-259-4724",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.