Active NPI
Fariborz Mazdisnian, MD
- Obstetrics & Gynecology Physician
- Panorama City, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- G63564
- Practice address
- 13652 Cantara St
Panorama City, CA 91402-5423 - Phone
- (818) 375-2000
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | G63564 | CA | Primary |
Addresses
Primary practice location
13652 Cantara St
Panorama City, CA 91402-5423
Mailing address
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G63564 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency and Acute Care Medical Corporation | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Obhg California, P.C. | Obstetrics & Gynecology | Current | Accepting new patients |
| New York University | Obstetrics & Gynecology | Current | Accepting new patients |
| Samir E. Hage, D.O., Inc. | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400
400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279
700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325
100 Hospital Rd
Ste 200
East Patchogue, NY 11772
Phone (631) 307-9737
1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
889 E Main St
Ste 308
Riverhead, NY 11901
Phone (631) 386-3500
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- fmazdisnian626996@nyumc.direct-ci.com
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.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Obstetrics & Gynecology
-
- Emergency Medicine Physician
- San Diego, CA
- NPI 1437103942
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Lancaster, CA
- NPI 1982863783
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Obstetrics & Gynecology Physician
- Redlands, CA
- NPI 1811184179
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Patchogue, NY
- NPI 1013724061
Hospital
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
-
- General Acute Care Hospital
- Patchogue, NY
- NPI 1831910355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1669520631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13652 CANTARA ST",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914025423",
"telephone_number": "818-375-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13652 CANTARA ST",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914025423",
"telephone_number": "818-375-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZDISNIAN",
"first_name": "FARIBORZ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "G63564",
"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": "13652 Cantara St",
"city": "Panorama City",
"state": "CA",
"country_code": "US",
"postal_code": "914025423",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.