NPIMap

Individual provider Active NPI

Saman Fakheri, M.D.

  • Internal Medicine Physician
  • Northridge, CA
National Provider Identifier
1790017218
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A107753 Issued in CA
Practice address
17075 Devonshire St Ste 201
Northridge, CA 91325-5405
Phone
(818) 923-5453
Fax
(310) 593-2521
NPI assigned
Feb 9, 2010
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A107753 CA Primary

Addresses

Primary practice location

17075 Devonshire St Ste 201
Northridge, CA 91325-5405

Mailing address

17075 Devonshire St Ste 201
Northridge, CA 91325-5407
Phone (818) 923-5453

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
I20110601000869 CA Practitioner - Cardiovascular Disease (Cardiology) 4486831302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Un of California, Irvine, College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17075 Devonshire St
Suite 201
Northridge, CA 91325-5407
Phone 8189235453113

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107753CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Saman Fakheri MD Inc CurrentSince Feb 5, 2015 Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Barlow Respiratory Hospital Past Accepting new patients

Locations

17075 Devonshire St
Ste 100
Northridge, CA 91325
Phone (800) 673-8185

17075 Devonshire St
Ste 201
Northridge, CA 91325
Phone (818) 365-9595

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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 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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1790017218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 201",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255407",
            "telephone_number": "818-923-5453",
            "fax_number": "310-593-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 201",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255405",
            "telephone_number": "818-923-5453",
            "fax_number": "310-593-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHERI",
        "first_name": "SAMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A107753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.