Individual provider Active NPI

Farnaz Sara Danaie, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1740045764
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63918 Issued in CA
Practice address
5100 W Goldleaf Cir
Los Angeles, CA 90056-1658
Phone
(323) 293-7171
NPI assigned
Feb 19, 2024
Last updated
May 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA63918 CA Primary

Addresses

Primary practice location

5100 W Goldleaf Cir
Los Angeles, CA 90056-1658

Mailing address

5100 W Goldleaf Cir
Los Angeles, CA 90056-1658

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430001149 CA Practitioner - Physician Assistant 9739529314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Laguna Niguel, CA 92677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA63918CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince May 1, 2024 Accepting new patients
Providence Medical Institute PastSince Feb 25, 2024 Accepting new patients

Locations

5100 W Goldleaf Cir
Fl 2
Los Angeles, CA 90056
Phone (323) 293-7171

Interoperability endpoints

  • Direct secure messaging: fdanaie3222660@oc.providencedirect.org

Organizations & group practices 2

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 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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1740045764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W GOLDLEAF CIR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W GOLDLEAF CIR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561658",
            "telephone_number": "323-293-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANAIE",
        "first_name": "FARNAZ",
        "middle_name": "SARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.