Mina Moussavian-Assadi, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

216492 Issued in MA

Practice address

5525 Etiwanda Ave
#212
Tarzana, CA 91356-3647

Phone

(818) 721-2400

NPI assigned

Sep 30, 2005

Last updated

Aug 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Mina Moussavian Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoussavianassadi622530@oc.providencedirect.org

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.

• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588

  Pediatrics

  Medicare reassignment NPD
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Providence Health System - Southern California

  dba Providence Saint Joseph Medical Center

  • General Acute Care Hospital
  • Burbank, CA
  • NPI 1336173269
  NPD (past)
• Tarzana Medical Center LLC

  dba Providence Cedars-Sinai Tarzana Medical Center

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  NPD (past)
• Baystate Medical Center Inc

  • Psychiatric Hospital Unit
  • Springfield, MA
  • NPI 1497756282
  NPD (past)
• Providence Health & Services - Wa

  dba Providence St Joseph Hospital

  • Skilled Nursing Facility
  • Chewelah, WA
  • NPI 1700038197
  NPD (past)
• St. Joseph's Hospital, Yonkers

  • General Acute Care Hospital
  • Yonkers, NY
  • NPI 1336236629
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1609863091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "#212",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563647",
            "telephone_number": "818-721-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSAVIAN-ASSADI",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "216492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001110",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINA",
            "last_name": "MOUSSAVIAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Karine Ekmekji Mouradian, MD
• Monica Moussanejad, DDS
• Bakhtiar Moussazadeh, MD
• Kenneth L Moy, M.D.
• Sataporn Muang-in, MD
• Mudjianto Chandra, M.D., Inc.
• Marvin Mungcal

• Pediatrics Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.