Individual provider Active NPI

Mina Sarbaz

  • Podiatrist
  • Valley Village, CA
National Provider Identifier
1609438647
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5935 Issued in CA
Practice address
12520 Magnolia Blvd Ste 304
Valley Village, CA 91607-2355
Phone
(818) 452-9902
NPI assigned
Jun 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5935 CA Primary

Addresses

Primary practice location

12520 Magnolia Blvd Ste 304
Valley Village, CA 91607-2355

Mailing address

1310 Barry Ave Apt 106
Los Angeles, CA 90025-3955
Phone (703) 819-2896

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230410001923 CA Practitioner - Podiatry 7517332331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5935CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Demian Inc CurrentSince May 1, 2023 Accepting new patients
Michael D. Kotzen, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Home Foot Care, Inc. Podiatrist CurrentSince Mar 1, 2023 Accepting new patients
Robert a Breiner PC Podiatrist Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

17215 Studebaker Rd
Cerritos, CA 90703
Phone (562) 756-7367

17215 Studebaker Rd
Ste 108
Cerritos, CA 90703
Phone (310) 750-4511

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

Interoperability endpoints

  • Direct secure messaging: mina.sarbaz.1@21432.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/21432/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1609438647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 BARRY AVE APT 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253955",
            "telephone_number": "703-819-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 MAGNOLIA BLVD STE 304",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072355",
            "telephone_number": "818-452-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARBAZ",
        "first_name": "MINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

Verify at the official NPI Registry.