Individual provider Active NPI

Mahtab Naji, MD

  • Internal Medicine Physician
  • San Clemente, CA
National Provider Identifier
1558949693
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A189001 Issued in CA
Practice address
638 Camino de Los Mares Ste D4
San Clemente, CA 92673-2855
Phone
(949) 542-8865
NPI assigned
Mar 30, 2021
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A189001 CA Primary

Addresses

Primary practice location

638 Camino de Los Mares Ste D4
San Clemente, CA 92673-2855

Mailing address

638 Camino de Los Mares Ste D4
San Clemente, CA 92673-2855
Phone (949) 542-8865

Other practice location 1

28188 Moulton Pkwy Apt 1228
Laguna Niguel, CA 92677-7515
Phone (949) 702-8475

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20231226001466 CA Practitioner - Internal Medicine 5395195812 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

638 Camino de Los Mares
Suite D4
San Clemente, CA 92673-2855
Phone (949) 542-8865

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A189001CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 2, 2023 Accepting new patients
Mozhgan Ashtari MD PC CurrentSince Jan 2, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Dec 2, 2023 Accepting new patients
Memorialcare Medical Foundation Internal Medicine CurrentSince May 25, 2024 Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

23141 Moulton Pkwy
Ste 202
Laguna Hills, CA 92653
Phone (949) 305-2711

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

638 Camino de los Mares
Ste D4
San Clemente, CA 92673
Phone (949) 542-8865

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mnaji860563@direct.memorialcare.org

Organizations & group practices 6

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 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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1558949693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES STE D4",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732855",
            "telephone_number": "949-542-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES STE D4",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732855",
            "telephone_number": "949-542-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28188 Moulton Pkwy Apt 1228",
            "address_purpose": "LOCATION",
            "city": "Laguna Niguel",
            "state": "CA",
            "postal_code": "926777515",
            "country_code": "US",
            "telephone_number": "949-702-8475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAJI",
        "first_name": "MAHTAB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A189001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.