Individual provider Active NPI

Benjamin Rostami, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1659830545
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A176597 Issued in CA
Practice address
1080 N Western Ave
Los Angeles, CA 90029
Phone
(310) 963-3035
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A176597 CA Primary

Addresses

Primary practice location

1080 N Western Ave
Los Angeles, CA 90029

Mailing address

719 N Roxbury Dr
Beverly Hills, CA 90210-3211
Phone (310) 963-3035

Other practice location 1

4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021
Phone (323) 783-4516

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20210818002327 CA Practitioner - Internal Medicine 0941549588 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Innovative Medical Solutions Inc a Medical Group Internal Medicine CurrentSince Jan 18, 2023 Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

4733 W Sunset Blvd
Fl 3
Los Angeles, CA 90027
Phone (323) 783-1431

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

2080 Century Park E
Ste 710
Los Angeles, CA 90067
Phone (310) 203-9818

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
San Judas Community Health Center IncLos Angeles, CA, CCN A01068 Federally qualified health center Corporate Officer
W-2 Managing Employee
Jul 8, 2021
Jul 8, 2021
San Judas Community Health Center IncLos Angeles, CA, CCN A01060 Federally qualified health center Corporate Officer
W-2 Managing Employee
Jul 8, 2021
Jul 8, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1659830545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 N ROXBURY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103211",
            "telephone_number": "310-963-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90029",
            "telephone_number": "310-963-3035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4733 W Sunset Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276021",
            "country_code": "US",
            "telephone_number": "323-783-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSTAMI",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A176597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.