Individual provider Active NPI

Homan Siman, MD

  • Internal Medicine Physician
  • Wilmington, CA
National Provider Identifier
1558456814
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A83240 Issued in CA
Practice address
1231 Avalon Blvd
Wilmington, CA 90744
Phone
(310) 835-7215
Fax
(310) 835-6520
NPI assigned
Oct 4, 2006
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A83240 CA Primary

Addresses

Primary practice location

1231 Avalon Blvd
Wilmington, CA 90744

Mailing address

1231 N Avalon Blvd
Wilmington, CA 90744
Phone (310) 835-7215

Other identifiers 1

IdentifierTypeStateIssuer
A832400MedicaidCA

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
I20050428000476 CA Practitioner - Internal Medicine 7719926849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Care Family Medical ClinicGroup PAC ID 5597707695, 4 clinicians
Healing Hand Family Care Clinics CorpGroup PAC ID 3072821644, 5 clinicians

Practice addresses (Care Compare)

1231 N Avalon Blvd
Wilmington, CA 90744-2601
Phone (310) 835-7215

81800 Doctor Carreon Blvd
Suite a
Indio, CA 92201-5595
Phone (760) 342-4242

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Family Medical Clinic CurrentSince Nov 8, 2004 Accepting new patients
Healing Hand Family Care Clinics Corp CurrentSince Nov 14, 2014 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

81800 Doctor Carreon Blvd
Ste A
Indio, CA 92201
Phone (760) 342-4242

1231 N Avalon Blvd
Wilmington, CA 90744
Phone (310) 835-5000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1558456814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "90744",
            "telephone_number": "310-835-7215",
            "fax_number": "310-835-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "90744",
            "telephone_number": "310-835-7215",
            "fax_number": "310-835-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMAN",
        "first_name": "HOMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A832400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, CA

Sources for this page

Verify at the official NPI Registry.