Individual provider Active NPI

Homayoon Lodeen, MD

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1730764416
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A195104 Issued in CA
Practice address
4500 Parsons Blvd
Flushing, NY 11355-2205
Phone
(718) 206-6768
Fax
(718) 206-6651
NPI assigned
Mar 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 A195104 CA Primary

Addresses

Primary practice location

4500 Parsons Blvd
Flushing, NY 11355-2205

Mailing address

2200 Old Quacco Rd Apt 3300
Pooler, GA 31322-0615
Phone (346) 269-8551

Other names 1

  • Mohammad Homayoon Lodeen Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002979 CA Practitioner - Hospitalist 7416496096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4501 X St
Sacramento, CA 95817-2229
Phone (916) 734-5959

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195104CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 21, 2024 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 21, 2024 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

2315 Stockton Blvd
Ste 2P101
Sacramento, CA 95817
Phone (800) 282-3284

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.

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": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1730764416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OLD QUACCO RD APT 3300",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313220615",
            "telephone_number": "346-269-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552205",
            "telephone_number": "718-206-6768",
            "fax_number": "718-206-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODEEN",
        "first_name": "HOMAYOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A195104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMAD HOMAYOON",
            "last_name": "LODEEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.