Individual provider Active NPI

Ardalan Minokadeh

  • Dermatology Physician
  • Los Angeles, CA
National Provider Identifier
1760749311
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A145210 Issued in CA
Practice address
9201 W Sunset Blvd Ste 602
Los Angeles, CA 90069-3707
Phone
(310) 246-0495
Fax
(310) 246-0496
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A145210 CA Primary

Addresses

Primary practice location

9201 W Sunset Blvd Ste 602
Los Angeles, CA 90069-3707

Mailing address

2285 Corporate Cir
Ste 200
Henderson, NV 89074-7759
Phone (702) 360-2763

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
I20180112000197 CA Practitioner - Dermatology 2668731951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

9201 W Sunset Blvd
Suite 602
Los Angeles, CA 90069-3707
Phone (310) 246-0495

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions151
Removal or shaving of skin growth1-10
Skin biopsy28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145210CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Dermatology CurrentSince Jan 2, 2019 Accepting new patients
J. Robert West, M.D., Inc Dermatology Past Accepting new patients

Locations

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

9201 W Sunset Blvd
Ste 602
West Hollywood, CA 90069
Phone (310) 246-0495

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

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 and National Provider Directory roles.

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1760749311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD STE 602",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900693707",
            "telephone_number": "310-246-0495",
            "fax_number": "310-246-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOKADEH",
        "first_name": "ARDALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A145210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.