NPIMap

Individual provider Active NPI

Kourosh Michael Kolahi, M.D.

  • Orthopaedic Hand Surgery Physician
  • Long Beach, CA
National Provider Identifier
1700143104
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
A127417 Issued in CA
Practice address
3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027
Phone
(562) 424-9000
Fax
(562) 424-9067
NPI assigned
Apr 23, 2012
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X A127417 CA Primary

Addresses

Primary practice location

3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027

Mailing address

3633 Long Beach Blvd Ste 100
Long Beach, CA 90807-6027
Phone (562) 424-9000

Other practice location 1

Msc Orthopaedic Surgery
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-4107

Other identifiers 1

IdentifierTypeStateIssuer
A127417OtherCAMEDICAL BOARD OF CALIFORNIA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180820000744 CA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 1951650308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
State University of New York at Buffalo School of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3633 Long Beach Blvd
Suite 100
Long Beach, CA 90807-4015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127417CAMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hand & Wrist Center Hand Surgery Current Accepting new patients
KMK Clinical Inc CurrentSince Jul 18, 2018 Accepting new patients
Ross Nathan MD, Inc. Hand Surgery PastSince Jul 21, 2024 Accepting new patients

Locations

3633 Long Beach Blvd
Ste 100
Long Beach, CA 90807
Phone (562) 424-9000

3918 Long Beach Blvd
Ste 100
Long Beach, CA 90807
Phone (562) 424-9000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kkolahi503624@direct.memorialcare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1700143104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 LONG BEACH BLVD STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076027",
            "telephone_number": "562-424-9000",
            "fax_number": "562-424-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 LONG BEACH BLVD STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908076027",
            "telephone_number": "562-424-9000",
            "fax_number": "562-424-9067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc Orthopaedic Surgery",
            "address_2": "1 University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-4107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLAHI",
        "first_name": "KOUROSH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "A127417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA LICENSE",
            "identifier": "A127417",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.