Individual provider Active NPI

Sasan Sani, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Northridge, CA
National Provider Identifier
1760702179
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A121006 Issued in CA
Practice address
17075 Devonshire St Ste 205
Northridge, CA 91325-5408
Phone
(818) 366-2977
Fax
(818) 360-3533
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A121006 CA
Internal Medicine Physician 207R00000X A121006 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A121006 CA Primary

Addresses

Primary practice location

17075 Devonshire St Ste 205
Northridge, CA 91325-5408

Mailing address

17075 Devonshire St Ste 205
Northridge, CA 91325-5408
Phone (818) 366-2977

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
I20160719000889 CA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7517250269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sani and Eshaghian MD IncGroup PAC ID 6002196508, 4 clinicians

Practice addresses (Care Compare)

17075 Devonshire St
Suite 205
Northridge, CA 91325-5408
Phone (844) 428-5864

Hospital & facility affiliations

  • Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278
  • Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761
  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624
  • Providence Holy Cross Med Ctr D/P SNF Nursing home, Mission Hills, CA, CCN 555074

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
A121006CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Aug 15, 2016 Accepting new patients
Sani and Eshaghian M.D., Inc. Pulmonary Disease CurrentSince Oct 9, 2016 Accepting new patients
County of Los Angeles CurrentSince Aug 15, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

17075 Devonshire St
Ste 205
Northridge, CA 91325
Phone (818) 366-2977

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence Holy Cross Medical CenterMission Hills, CA, CCN 555074 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 14, 2023
Oct 14, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1760702179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 205",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "818-366-2977",
            "fax_number": "818-360-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 205",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "818-366-2977",
            "fax_number": "818-360-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANI",
        "first_name": "SASAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2023-12-12",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A121006",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A121006",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A121006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.