Individual provider Active NPI

Mohammad Hasan Malekzadeh, M.D.

  • Pediatric Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1639282072
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
A25585 Issued in CA
Practice address
10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075
Phone
(310) 206-3952
Fax
(310) 206-0209
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X A25585 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075

Mailing address

10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075
Phone (310) 206-3952

Other identifiers 2

IdentifierTypeStateIssuer
00A255850MedicaidCA
GR0053510MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109001162 CA Practitioner - NephrologyPractitioner - Pediatric Medicine 7911925763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 4587568829, 97 clinicians

Practice addresses (Care Compare)

10833 Le Conte Ave
Los Angeles, CA 90095-3075

10833 Leconte Ave
Los Angeles, CA 90095-3075
Phone (310) 825-9124

200 Medical Plaza
Los Angeles, CA 90095-0001

300 Medical Plaza
Los Angeles, CA 90095-0001

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
82.13
Promoting interoperability
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A25585CAMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatric Nephrology CurrentSince Jul 1, 1992 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Pediatrics Past Accepting new patients

Locations

10833 Le Conte Ave
#12441
Los Angeles, CA 90095
Phone (310) 206-3952

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

200 Medical Plz 265
Los Angeles, CA 90095

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Interoperability endpoints

  • Direct secure messaging: mmalekzadeh43173@direct.uclahealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639282072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "12-441 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-3952",
            "fax_number": "310-206-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "12-441 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-3952",
            "fax_number": "310-206-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEKZADEH",
        "first_name": "MOHAMMAD",
        "middle_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "A25585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A255850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.