Individual provider Active NPI

Sam Bakshian, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Los Angeles, CA
National Provider Identifier
1760406169
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G77202 Issued in CA
Practice address
6330 San Vicente Blvd
Suite 310
Los Angeles, CA 90048-5425
Phone
(310) 855-0751
Fax
(310) 358-2453
NPI assigned
Jul 27, 2006
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X G77202 CA Primary

Addresses

Primary practice location

6330 San Vicente Blvd
Suite 310
Los Angeles, CA 90048-5425

Mailing address

6330 San Vicente Blvd
Suite 310
Los Angeles, CA 90048-5425
Phone (310) 855-0751

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
I20051206001034 CA Practitioner - Orthopedic Surgery 7113987082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sam Bakshian MD a Medical CorporationGroup PAC ID 5496950594, 2 clinicians

Practice addresses (Care Compare)

42544 10TH St W
Suite G
Lancaster, CA 93534-7079
Phone (310) 855-0751

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77202CAMDOrthopaedic Surgery of the Spine Physician

Organizations & group practices 1

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 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1760406169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD",
            "address_2": "SUITE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485425",
            "telephone_number": "310-855-0751",
            "fax_number": "310-358-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD",
            "address_2": "SUITE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485425",
            "telephone_number": "310-855-0751",
            "fax_number": "310-358-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSHIAN",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G77202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.