NPIMap

Individual provider Active NPI

Benjamin Behroozan, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1750440681
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A41374 Issued in CA
Practice address
2221 Lincoln Blvd # 200
Santa Monica, CA 90405-1320
Phone
(310) 396-9999
Fax
(310) 664-8901
NPI assigned
Dec 6, 2006
Last updated
Jan 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A41374 CA Primary

Addresses

Primary practice location

2221 Lincoln Blvd # 200
Santa Monica, CA 90405-1320

Mailing address

2221 Lincoln Blvd # 200
Santa Monica, CA 90405-1320
Phone (310) 396-9999

Other identifiers 1

IdentifierTypeStateIssuer
00A413741MedicaidCA

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
I20051209000359 CA Practitioner - General PracticePractitioner - Interventional Pain Management 8325099583 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41374CAMDOptician
A41374CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthylife MG Corp Family Medicine CurrentSince Aug 12, 2024 Accepting new patients
Benjamin Behroozan MD Inc CurrentSince Dec 1, 1986 Accepting new patients
Janesri de Silva M.D. a Prof Corp CurrentSince Jan 1, 2025 Accepting new patients
Coastline Hospice Inc Family Medicine Current Accepting new patients
Pediatric Affiliates Medical Group Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

1442 Foothill Blvd
La Canada Flintridge, CA 91011
Phone (747) 233-3295

5255 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 463-7262

5255 W Sunset Blvd
Fl 1
Los Angeles, CA 90027

504 S Sierra Madre Blvd
Pasadena, CA 91107
Phone (626) 795-8811

2221 Lincoln Blvd
#200
Santa Monica, CA 90405
Phone (310) 396-9999

2221 Lincoln Blvd
Ste 200
Santa Monica, CA 90405
Phone (310) 396-9999

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1750440681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD # 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-396-9999",
            "fax_number": "310-664-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD # 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-396-9999",
            "fax_number": "310-664-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHROOZAN",
        "first_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A41374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A413741",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.