Individual provider Active NPI

Mahboobeh Saifiabolhassan

  • Internal Medicine Physician
  • Tarzana, CA
National Provider Identifier
1558930875
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A210089 Issued in CA
Practice address
18133 Ventura Blvd Ste 405
Tarzana, CA 91356-3726
Phone
(310) 423-2823
NPI assigned
Jun 21, 2021
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT224234 PA
Internal Medicine Physician 207R00000X A210089 CA Primary

Addresses

Primary practice location

18133 Ventura Blvd Ste 405
Tarzana, CA 91356-3726

Mailing address

4140 W 190TH St FL 2
Torrance, CA 90504-5513

Other practice location 1

720 US Highway 27 N
Marshall, MI 49068-9609
Phone (269) 781-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240920002117 MI Practitioner - Internal Medicine 9931501186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

200 N Madison St
Marshall, MI 49068-1143
Phone (269) 781-4271

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.06 of 100Reported as group
Quality
85.32
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT224234PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Sep 9, 2024 Accepting new patients
Ella E M Brown Charitable Circle Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients

Locations

13444 Preston Dr
Marshall, MI 49068
Phone (269) 789-3939

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

720 US Highway 27 N
Marshall, MI 49068
Phone (269) 781-6600

Interoperability endpoints

  • Direct secure messaging: mahboobeh.saifiabolhassan.1@9698.direct.athenahealth.com

Organizations & group practices 2

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 4

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1558930875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST FL 2",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18133 VENTURA BLVD STE 405",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563726",
            "telephone_number": "310-423-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 US Highway 27 N",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MI",
            "postal_code": "490689609",
            "country_code": "US",
            "telephone_number": "269-781-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAIFIABOLHASSAN",
        "first_name": "MAHBOOBEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT224234",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A210089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.