Individual provider Active NPI

Simon Akhnoukh

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1609544535
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A200843 Issued in CA
Practice address
950 E 3Rd St Apt 1401
Los Angeles, CA 90013-2674
Phone
(727) 481-8149
NPI assigned
Sep 3, 2021
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A200843 CA Primary

Addresses

Primary practice location

950 E 3Rd St Apt 1401
Los Angeles, CA 90013-2674

Mailing address

950 E 3Rd St Apt 1401
Los Angeles, CA 90013-2674
Phone (727) 481-8149

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
I20250416002389 CA Practitioner - General Surgery 4880039510 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A200843CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Izuchukwu Okpara MD Inc Surgery CurrentSince Mar 9, 2025 Accepting new patients

Locations

5430 Arlington Ave
Riverside, CA 92504
Phone (714) 458-4617

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

28212 Kelly Johnson Pkwy
Ste 200
Valencia, CA 91355
Phone (661) 388-5945

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1609544535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E 3RD ST APT 1401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132674",
            "telephone_number": "727-481-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E 3RD ST APT 1401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900132674",
            "telephone_number": "727-481-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHNOUKH",
        "first_name": "SIMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A200843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.