Omid Benjamin Mehdizadeh

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

150014 Issued in CA

Practice address

2125 Arizona Ave
Santa Monica, CA 90404-1337

Phone

(310) 829-8701

Fax

(310) 315-4062

NPI assigned

Sep 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Otolaryngology

Education

University of California, Davis School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290
• Lompoc Valley Medical Center Hospital, Lompoc, CA, CCN 050110
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Saint Johns Medical Foundation

  dba Saint John's Physician Partners

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734
  Medicare reassignment Care Compare group NPD
• Pacific Specialists Imaging Inc

  • Radiology Clinic/Center
  • Los Angeles, CA
  • NPI 1659503548
  NPD
• Saint John's Health Clinic

  dba Providence Saint John's Health Clinic

  • Specialist
  • Santa Monica, CA
  • NPI 1336438902
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lompoc Valley Medical Center

  • General Acute Care Hospital
  • Lompoc, CA
  • NPI 1194711952
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1252713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1770816464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD FL 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-829-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 ARIZONA AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041337",
            "telephone_number": "310-829-8701",
            "fax_number": "310-315-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHDIZADEH",
        "first_name": "OMID",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-12",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "150014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omehdizadeh935745@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2125 Arizona Ave",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904041337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omehdizadeh935745@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11645 Wilshire Blvd Ste 600",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900256807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janet Medrano Reyes, LCSW, PPSC
• Meena Said MD Corporation
• Megan B. C. Smith, PH.D., a Psychology Corporation
• Megan Rustad, DDS Inc
• Abigail Meger
• Holly Mehr, MD
• Nima Mehran, M.D.
• Hardik Mehta, MD
• Stephen B. Meisel, M.D.
• Oleg Melamed, MD

• Otolaryngology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.