NPIMap

Individual provider Active NPI

Mehdi Khorsandi, M.D.

  • Gastroenterology Physician
  • Glendale, CA
National Provider Identifier
1588607691
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A52802 Issued in CA
Practice address
1510 S Central Ave
600
Glendale, CA 91204-2500
Phone
(818) 500-1676
Fax
(818) 500-8360
NPI assigned
Jun 14, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A52802 CA Primary

Addresses

Primary practice location

1510 S Central Ave
600
Glendale, CA 91204-2500

Mailing address

1510 S Central Ave
600
Glendale, CA 91204-2500
Phone (818) 500-1676

Other names 1

  • Dr. Marc Khorsandi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000442 CA Practitioner - Gastroenterology 5597734475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Texas Medical School at San Antonio, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1510 S Central Ave
Suite 620
Glendale, CA 91204-2598

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy135
Upper gastrointestinal (GI) endoscopy for acid reflux129

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52802CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mehdi Khorsandi MD Inc. Gastroenterology CurrentSince May 1, 2006 Accepting new patients
Howard M Hack MD PC Past Accepting new patients

Locations

500 E Mountain View St
Barstow, CA 92311
Phone (460) 256-1026

1510 S Central Ave
Ste 620
Glendale, CA 91204
Phone (818) 325-6117

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15190/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mehdi.khorsandi.1@15190.direct.athenahealth.com
  • Direct secure messaging: mehdi.khorsandi.p1@direct.lakeside.nextgenshare.com
  • Direct secure messaging: mkhorsandi583461@christushealth.direct-ci.net

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1588607691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "600",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-500-1676",
            "fax_number": "818-500-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "600",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-500-1676",
            "fax_number": "818-500-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORSANDI",
        "first_name": "MEHDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A52802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARC",
            "last_name": "KHORSANDI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.