Individual provider Active NPI

Isam Mawas, MD

  • Infectious Disease Physician
  • Culver City, CA
National Provider Identifier
1790971422
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A98516 Issued in CA
Practice address
3831 Hughes Ave Ste 604
Culver City, CA 90232-6848
Phone
(310) 730-8606
Fax
(318) 973-2420
NPI assigned
Sep 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X A98516 CA Primary

Addresses

Primary practice location

3831 Hughes Ave Ste 604
Culver City, CA 90232-6848

Mailing address

9808 Venice Blvd Ste 603
Culver City, CA 90232-6819
Phone (310) 730-8606

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
I20170919004322 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4284721788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime 5 Medical Group IncGroup PAC ID 0941623961, 4 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 788-0074

8815 W Pico Blvd
Los Angeles, CA 90035-3301
Phone (818) 859-4486

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Southern California Hospital at Hollywood Hospital, Hollywood, CA, CCN 050135

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Promoting interoperability
81
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
86.78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98516CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime 5 Medical Group Inc Single Specialty CurrentSince Feb 7, 2022 Accepting new patients
Isam Mawas MD Inc Single Specialty CurrentSince Jul 26, 2017 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients
Pejman D Shamekh, M.D., Inc Single Specialty Past Accepting new patients
Ipc Hospitalists of New Mexico, Inc Single Specialty Past Accepting new patients

Locations

9808 Venice Blvd
Ste 603
Culver City, CA 90232
Phone (310) 204-4565

3831 Hughes Ave
Ste 604
Culver City, CA 90232
Phone (310) 730-8606

5901 W Olympic Blvd
Ste 404
Los Angeles, CA 90036
Phone (323) 928-9999

8815 W Pico Blvd
Los Angeles, CA 90035
Phone (323) 938-9999

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 5

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 3

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1790971422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD STE 603",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326819",
            "telephone_number": "310-730-8606",
            "fax_number": "318-973-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 604",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326848",
            "telephone_number": "310-730-8606",
            "fax_number": "318-973-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWAS",
        "first_name": "ISAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A98516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.