Individual provider Active NPI

Farzin Benjamin Pedouim, M.D.

  • Neurology Physician
  • Huntington Beach, CA
National Provider Identifier
1649567165
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A122634 Issued in CA
Practice address
18377 Beach Blvd Ste 330
Huntington Beach, CA 92648
Phone
(949) 239-4410
Fax
(949) 229-6795
NPI assigned
Jul 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A122634 CA Primary

Addresses

Primary practice location

18377 Beach Blvd Ste 330
Huntington Beach, CA 92648

Mailing address

18377 Beach Blvd Ste 330
Huntington Beach, CA 92648-1350
Phone (949) 239-4410

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
I20150202000011 CA Practitioner - Neurology 1254655848 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kern Valley Healthcare DistrictGroup PAC ID 8628069689, shared by 2 NPIs, 19 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

2080 Century Park E
Suite 1403
Los Angeles, CA 90067-2017
Phone (844) 638-7637

File Number
Suite 54701
Los Angeles, CA 90074-4701

PO Box
Suite 1628
Lake Isabella, CA 93240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122634CAMDClinical Social Worker
A122634CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology and Cognitive Neuroscience Institute, Inc. Neurology CurrentSince Sep 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 5, 2015 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 5, 2015 Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
H Squared Health PastSince Sep 27, 2020 Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Huy T Ho MD, Inc PastSince Jan 1, 2019 Accepting new patients
Northern California Rehabilitation Hospital, LLC Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

18377 Beach Blvd
Ste 330
Huntington Beach, CA 92648
Phone (844) 638-7637

25745 Barton Rd
Loma Linda, CA 92354
Phone (909) 567-2527

11370 Anderson St
Ste B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

2080 Century Park E
Ste 1403
Los Angeles, CA 90067
Phone (844) 638-7637

8631 W 3rd St
Ste 1030
Los Angeles, CA 90048
Phone (310) 341-7886

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (760) 533-4541

359 San Miguel Dr
Ste 105
Newport Beach, CA 92660
Phone (909) 558-2880

1401 N Palm Canyon Dr
Ste 103
Palm Springs, CA 92262
Phone (760) 320-3538

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: fpedouim77413@direct.llu.edu

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1649567165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18377 BEACH BLVD STE 330",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481350",
            "telephone_number": "949-239-4410",
            "fax_number": "949-229-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18377 BEACH BLVD STE 330",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92648",
            "telephone_number": "949-239-4410",
            "fax_number": "949-229-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDOUIM",
        "first_name": "FARZIN",
        "middle_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A122634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.