Individual provider Active NPI

Babak Kosari, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Northridge, CA
National Provider Identifier
1639101793
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4472 Issued in CA
Practice address
17075 Devonshire St
Suite 304
Northridge, CA 91325-1600
Phone
(818) 831-1000
Fax
(818) 831-5700
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4472 CA Primary

Addresses

Primary practice location

17075 Devonshire St
Suite 304
Northridge, CA 91325-1600

Mailing address

17075 Devonshire St
Suite 304
Northridge, CA 91325-1600
Phone (818) 831-1000

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
I20041004000648 CA Practitioner - Podiatry 3779542022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17075 Devonshire St
Suite 304
Northridge, CA 91325-5415
Phone (818) 831-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue138
Removal of skin lesions1-10
Removal of nail tissue628
Removal or shaving of skin growth424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4472CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Babak Kosari, D.P.M., Inc. Foot & Ankle Surgery CurrentSince Jan 1, 2004 Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

3390 Motor Ave
Los Angeles, CA 90034
Phone (818) 365-0094

14901 Rinaldi St
Ste 320
Mission Hills, CA 91345
Phone (818) 365-1616

17075 Devonshire St
Ste 304
Northridge, CA 91325
Phone (818) 831-1000

23206 Lyons Ave
Ste 206
Santa Clarita, CA 91321
Phone (661) 259-2388

23206 Lyons Ave
Ste 209
Santa Clarita, CA 91321
Phone (310) 803-0443

24355 Lyons Ave
Ste 230
Santa Clarita, CA 91321
Phone (661) 259-2500

25775 McBean Pkwy
Ste 107
Valencia, CA 91355
Phone (661) 259-9680

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCCDA/Endpoint/DGCCDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCCDA

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1639101793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 304",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-1000",
            "fax_number": "818-831-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 304",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-1000",
            "fax_number": "818-831-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSARI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.