Individual provider Active NPI

Babak Bobby Rostami, M.D. INTERNAL MEDICI

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1811188048
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A99776 Issued in CA
Practice address
1080 N Western Ave
Los Angeles, CA 90029-2310
Phone
(323) 957-8787
Fax
(323) 957-8777
NPI assigned
Aug 5, 2007
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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 A99776 CA Primary

Addresses

Primary practice location

1080 N Western Ave
Los Angeles, CA 90029-2310

Mailing address

1080 N Western Ave
Los Angeles, CA 90029-2310
Phone (323) 957-8787

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
I20141205000015 CA Practitioner - Internal MedicinePractitioner - General Practice 3678895430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A99776CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Judas Community Health Center, Inc. CurrentSince Jan 8, 2019 Accepting new patients
Babak Bobby Rostami MD Apc Internal Medicine Current Accepting new patients

Locations

1080 N Western Ave
Los Angeles, CA 90029
Phone (323) 957-3737

2972 Wilshire Blvd
Los Angeles, CA 90010
Phone (213) 484-0000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1811188048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292310",
            "telephone_number": "323-957-8787",
            "fax_number": "323-957-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292310",
            "telephone_number": "323-957-8787",
            "fax_number": "323-957-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTAMI",
        "first_name": "BABAK",
        "middle_name": "BOBBY",
        "credential": "M.D. INTERNAL MEDICI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A99776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.