Individual provider Active NPI

Michael Kourosh Ghiam, M.D.

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1740711944
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
184572 Issued in CA
Practice address
2080 Century Park E Ste 1700
Los Angeles, CA 90067-2020
Phone
(818) 625-8729
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 184572 CA Primary

Addresses

Primary practice location

2080 Century Park E Ste 1700
Los Angeles, CA 90067-2020

Mailing address

23318 Park Colombo
Calabasas, CA 91302-2810
Phone (818) 625-8729

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
I20230809003191 CA Practitioner - Otolaryngology 9234591165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Vanderbilt University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Group of Los AngelesGroup PAC ID 4880902790, 7 clinicians

Practice addresses (Care Compare)

2080 Century Park E
Suite 1700
Los Angeles, CA 90067-2020
Phone (818) 625-8729

5525 Etiwanda Ave
Suite 211
Tarzana, CA 91356-6136
Phone (818) 609-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184572CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skull Base Surgery Institute Professional Corporation Otolaryngology Current Accepting new patients
ENT Group of Los Angeles Otolaryngology CurrentSince Oct 1, 2023 Accepting new patients
Michael Ghiam MD PC Otolaryngology CurrentSince Jul 26, 2023 Accepting new patients
Ghiam Eye PC PastSince Dec 1, 2023 Accepting new patients

Locations

2080 Century Park E
Ste 1700
Los Angeles, CA 90067
Phone (310) 201-0007

4955 Van Nuys Blvd
Ste 505
Sherman Oaks, CA 91403
Phone (818) 265-8300

5525 Etiwanda Ave
Ste 312
Tarzana, CA 91356
Phone (310) 360-0332

5525 Etiwanda Ave
Ste 211
Tarzana, CA 91356
Phone (818) 609-0600

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: yiz9017@direct.weillcornell.org
  • Direct secure messaging: michael.ghiam@10367565889540.direct.elationemr.com
  • Direct secure messaging: yiz9017@direct.nyp.org

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 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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1740711944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23318 PARK COLOMBO",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913022810",
            "telephone_number": "818-625-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 1700",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672020",
            "telephone_number": "818-625-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIAM",
        "first_name": "MICHAEL",
        "middle_name": "KOUROSH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "184572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.