Amani Eldessouky, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A56426 Issued in CA

Practice address

1704 W Manchester Ave
Suite 109
Los Angeles, CA 90047-3034

Phone

(323) 778-8485

Fax

(310) 778-4452

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Obstetrics/GynecologyAlso: Family Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• GL Home Health Care, Inc Home health agency, Burbank, CA, CCN 059740

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Nueva Esperanza Healthcare Medical Clinic Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1083767875
  Medicare reassignment Authorized official
• Nueva Esperanza Healthcare Medical Clinic Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1063781565
  NPD (past) Authorized official
• Nueva Esperanza Healthcare Medical Clinic Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1518236017
  NPD (past) Authorized official
• Ahmc Garfield Medical Center LP

  • General Acute Care Hospital
  • Monterey Park, CA
  • NPI 1730171265
  NPD (past)
• Gardena Hospital LP

  • Institutional Pharmacy
  • Gardena, CA
  • NPI 1669491700
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• GL Home Health Care, Inc.

  • Home Health Agency
  • Burbank, CA
  • NPI 1447668991
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1528074044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "address_2": "SUITE 109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-778-8485",
            "fax_number": "323-778-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 W MANCHESTER AVE",
            "address_2": "SUITE 109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900473034",
            "telephone_number": "323-778-8485",
            "fax_number": "310-778-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDESSOUKY",
        "first_name": "AMANI",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A564260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Patrice Elder-Wolff, FNP
• Alyssa Elder, PT
• Charlotte Ebony Elder, M.A.
• Elderly Behavioral Wellness Services Inc
• Elderly Love Homecare Services LLC
• Caine Eldridge
• Dena D Eldridge
• Joshua Clifton Eldridge, MD
• Molly A Eldridge, DPT
• Robert L Eldridge, M.D.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.

Verify at the official NPI Registry.