Individual provider Active NPI

Kasra Khatibi, MD

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1548512809
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A127670 Issued in CA
Practice address
1520 San Pablo St Ste 3800
Los Angeles, CA 90033-5328
Phone
(323) 442-5720
NPI assigned
Oct 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X A127670 CA
Diagnostic Radiology Physician 2085R0202X A127670 CA
Neurology Physician 2084N0400X A127670 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 3800
Los Angeles, CA 90033-5328

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5720

Other practice location 1

1245 16th St Ste 105
Santa Monica, CA 90404-1239
Phone (310) 301-6800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kasra.khatibi@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20160711002081 CA Practitioner - NeurologyPractitioner - Neurosurgery 8325330442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Neurosurgery
Education
University of California, San Francisco School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

  • Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127670CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Hospitalist Network Medical Group Inc CurrentSince Jan 23, 2019 Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
The Regents of the University of California Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

301 W Huntington Dr
Ste 607
Arcadia, CA 91007
Phone (626) 445-4051

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

16260 Ventura Blvd
Ste 700
Encino, CA 91436
Phone (310) 479-0500

1520 San Pablo St
Ste 3800
Los Angeles, CA 90033
Phone (323) 442-5720

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: kkhatibi941342@oc.providencedirect.org
  • Direct secure messaging: kasra.khatibi@direct.usc.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1548512809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 3800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335328",
            "telephone_number": "323-442-5720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 16th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041239",
            "country_code": "US",
            "telephone_number": "310-301-6800",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATIBI",
        "first_name": "KASRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "CA",
            "license": "A127670",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A127670",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A127670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kasra.khatibi@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 3800",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.