Individual provider Active NPI

Elham Khanifar, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Long Beach, CA
National Provider Identifier
1811217037
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A106655 Issued in CA
Practice address
2801 Atlantic Ave
Lbmmc Department of Pathology
Long Beach, CA 90806-1701
Phone
(562) 933-0717
Fax
(562) 933-0791
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A106655 CA Primary

Addresses

Primary practice location

2801 Atlantic Ave
Lbmmc Department of Pathology
Long Beach, CA 90806-1701

Mailing address

2801 Atlantic Ave
Lbmmc Department of Pathology
Long Beach, CA 90806-1701
Phone (562) 933-0717

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
I20130212000427 CA Practitioner - Pathology 1951555333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Beach Memorial Pathology Medical Group, Inc.Group PAC ID 8426001363, 12 clinicians

Practice addresses (Care Compare)

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-0716

9920 Talbert Ave
Fountain Valley, CA 92708-5153
Phone (562) 933-0716

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
58
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Beach Memorial Pathology Medical Group Inc. CurrentSince Dec 31, 2012 Accepting new patients
Long Beach Memorial Pathology Medical Group, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Dec 31, 2012 Accepting new patients
Jason R Koh DO Inc Past Accepting new patients

Locations

2801 Atlantic Ave
Fl Specialty
Long Beach, CA 90806
Phone (562) 933-8749

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1801 W Olympic Blvd
Pasadena, CA 91199

3865 Jackson St
Riverside, CA 92503
Phone (909) 688-2211

Organizations & group practices 3

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1811217037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "address_2": "LBMMC DEPARTMENT OF PATHOLOGY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-0717",
            "fax_number": "562-933-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "address_2": "LBMMC DEPARTMENT OF PATHOLOGY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-0717",
            "fax_number": "562-933-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANIFAR",
        "first_name": "ELHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A106655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.