Individual provider Active NPI

Ali Khoynezhad, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Long Beach, CA
National Provider Identifier
1659329209
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
A92674 Issued in CA
Practice address
3828 Schaufele Ave Ste 340
Long Beach, CA 90808-1793
Phone
(562) 427-5388
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 23507 NE
Surgery Physician 208600000X A92674 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A92674 CA Primary

Addresses

Primary practice location

3828 Schaufele Ave Ste 340
Long Beach, CA 90808-1793

Mailing address

3828 Schaufele Ave Ste 340
Long Beach, CA 90808-1793

Other identifiers 1

IdentifierTypeStateIssuer
47078557583MedicaidNE

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
I20141106000951 CA Practitioner - Thoracic Surgery 5294749222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

3828 Schaufele Ave
Suite 340
Long Beach, CA 90808-1793
Phone (562) 988-9333

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Coronary artery bypass graft (CABG)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A92674CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Jul 31, 2017 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Vassar Brothers Hospital Past Accepting new patients
Creighton University Surgery Past Accepting new patients
Nebraska Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Creighton University Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

3828 Schaufele Ave
Ste 200
Long Beach, CA 90808
Phone (657) 241-8990

3828 Schaufele Ave
Ste 340
Long Beach, CA 90808
Phone (562) 427-5388

2888 Long Beach Blvd
Ste 165
Long Beach, CA 90806
Phone (562) 595-5380

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: akhoynezhad453414@direct.memorialcare.org

Organizations & group practices 8

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1659329209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE STE 340",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE STE 340",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081793",
            "telephone_number": "562-427-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOYNEZHAD",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "NE",
            "license": "23507",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A92674",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A92674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078557583",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.