Benjamin Behroozan M D Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A41374 Issued in CA

Legal business name

BENJAMIN BEHROOZAN M D INC

Doing business as

Great Care Medical Group

Practice address

2221 Lincoln Blvd
Suite 200
Santa Monica, CA 90405-1320

Phone

(310) 396-9999

Fax

(310) 664-8901

NPI assigned

Dec 22, 2006

Last updated

Jul 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Behroozan, M.D.NPI 1750440681

Title

Medical Director

Phone

(310) 396-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GREAT CARE MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Benjamin Behroozan MD Inc

  dba Great Care Medical Group

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Los Angeles, CA
  • NPI 1194949180

  O20050204000133

  Same enrollment

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Behroozan, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1750440681
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1639234362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-396-9999",
            "fax_number": "310-664-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-396-9999",
            "fax_number": "310-664-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN BEHROOZAN M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "BEHROOZAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL  DIRECTOR",
        "authorized_official_telephone_number": "310-396-9999",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A41374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0026800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT CARE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moshe Ben-Roohi, M.D.
• Sharon Ben-Roohi, D.D.S.
• Kristin A Bendikson, M.D.
• Lana Mae Benedek, M.D.
• Benjamin C Bengs, MD
• Ehteram Benji Behroozan, D.D.S.
• Danny Benmoshe, M.D.
• Rachel S Bennahum
• Bennett Surgery Centers a Medical Corp
• Emma Bennett, M.S.W., LCSW #79627

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.