Active NPI
Mitra Tabassian, D.P.M.
- Podiatrist
- Inglewood, CA
National Provider Identifier
1508801317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E40610
- Practice address
- 426 E Arbor Vitae St
Inglewood, CA 90301-3450 - Phone
- (310) 671-0004
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E40610 | CA | Primary |
Addresses
Primary practice location
426 E Arbor Vitae St
Inglewood, CA 90301-3450
Mailing address
PO Box 965
Palos Verdes Estates, CA 90274-0965
Phone (310) 671-0004
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061207000371 | CA | Practitioner - Podiatry | 9537168299 | Practice locations: Inglewood, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
994 S la Brea Ave
Inglewood, CA 90301-3816
Phone (310) 671-2420
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 445 |
| Removal or shaving of skin growth | 437 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E40610 | CA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1508801317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 965",
"city": "PALOS VERDES ESTATES",
"state": "CA",
"postal_code": "902740965",
"telephone_number": "310-671-0004",
"fax_number": "310-330-4557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 E ARBOR VITAE ST",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903013450",
"telephone_number": "310-671-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABASSIAN",
"first_name": "MITRA",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-17",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E40610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.