Mike Azarya Seliktar, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4929 Wilshire Blvd
Suite 510
Los Angeles, CA 90010-3808

Phone

(562) 904-3999

Fax

(855) 688-6746

NPI assigned

Mar 21, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment Care Compare group NPD
• Allstate Psychological and Behavioral Services

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1386164184
  Medicare reassignment

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1578734125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 FRANKLIN AVE. # 810",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90046",
            "telephone_number": "323-851-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 WILSHIRE BLVD",
            "address_2": "SUITE 510",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103808",
            "telephone_number": "562-904-3999",
            "fax_number": "855-688-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIKTAR",
        "first_name": "MIKE",
        "middle_name": "AZARYA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-21",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Self-Improvement and Alternative Measures, Inc
• Selfish Moms
• Alicia Marie Selga, DNAP
• Benjamin Joseph Seligman, MD
• David Seligson, MD
• Sarah Selim
• Lisa Karon Selin, LCSW, PHD
• Selina Matthews
• Eli Jacob Selkin, L.C.S.W.
• Mark Anthony Selleck, M.D., PH.D.

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.