NPIMap

Individual provider Active NPI

Moussa Faminini, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Encino, CA
National Provider Identifier
1629084843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A031134 Issued in CA
Practice address
16661 Ventura Blvd
# 818
Encino, CA 91436
Phone
(818) 501-3320
Fax
(818) 501-3414
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A031134 CA Primary

Addresses

Primary practice location

16661 Ventura Blvd
# 818
Encino, CA 91436

Mailing address

16661 Ventura Blvd
# 818
Encino, CA 91436
Phone (818) 501-3320

Other identifiers 3

IdentifierTypeStateIssuer
A31134OtherCABLUE CROSS
00A311340OtherCABLUE SHIELD
00A311340MedicaidCA

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
I20110321000177 CA Practitioner - Internal Medicine 7517082225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16661 Ventura Blvd
Suite 818
Encino, CA 91436-1999
Phone (818) 501-3320

Hospital & facility affiliations

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
A031134CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moussa Faminini MD Inc Endocrinology, Diabetes & Metabolism CurrentSince Jun 26, 2010 Accepting new patients

Locations

16661 Ventura Blvd
Ste 818
Encino, CA 91436
Phone (818) 501-3320

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.

Hospital & facility affiliations 7

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629084843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD",
            "address_2": "# 818",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-501-3320",
            "fax_number": "818-501-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD",
            "address_2": "# 818",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-501-3320",
            "fax_number": "818-501-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMININI",
        "first_name": "MOUSSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A031134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A31134",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A311340",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A311340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.