NPIMap

Individual provider Active NPI

Muzammil Memon, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Van Nuys, CA
National Provider Identifier
1629738158
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
A175836 Issued in CA
Practice address
6815 Noble Ave
Van Nuys, CA 91405-3796
Phone
(818) 901-6600
NPI assigned
Dec 24, 2021
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 175836 CA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A175836 CA Primary

Addresses

Primary practice location

6815 Noble Ave
Van Nuys, CA 91405-3796

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
175836OtherCAMBC

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Address

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230628002303 NM Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 5799163267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2550 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (800) 421-8274

2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)33
Upper limb (arm) arthroscopy (minimally invasive joint repair)77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175836CAMDOrthopaedic Surgery Physician
A175836CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Three Crosses Regional Hospital LLC Single Specialty CurrentSince Aug 1, 2023 Accepting new patients

Locations

2550 Samaritan Dr
Las Cruces, NM 88001
Phone (575) 522-7247

2560 Samaritan Dr
Las Cruces, NM 88001
Phone (575) 800-3868

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 6

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": "1640304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1629738158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 NOBLE AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053796",
            "telephone_number": "818-901-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "MUZAMMIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-24",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "175836",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A175836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBC",
            "identifier": "175836",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Address",
            "affiliation": "N",
            "address_1": "35 Haven Ave",
            "city": "Port Washington",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110503647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.