Individual provider Active NPI

Mitra Nadim, M.D.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1871529248
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A63716 Issued in CA
Practice address
1520 San Pablo St
Suite 1000
Los Angeles, CA 90033-5310
Phone
(323) 442-5100
Fax
(323) 442-5641
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A63716 CA Primary

Addresses

Primary practice location

1520 San Pablo St
Suite 1000
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-1309
Phone (323) 442-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mitra.nadim@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20090128000344 CA Practitioner - Nephrology 6507920006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of California, Geffen School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Non-Contracted LLCGroup PAC ID 6901263672, 18 clinicians
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Los Angeles, CA 90089-0112
Phone (323) 865-3000

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63716CAMDGeneral Practice Dentistry
A63716CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Non-Contracted LLC Nephrology CurrentSince May 1, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2009 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2009 Accepting new patients
Usc Internal Medicine, Inc. Nephrology Past Accepting new patients
Usc Cardiothoracic Surgeon'S Past Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

1450 San Pablo St
Ste HC46200
Los Angeles, CA 90033

1510 San Pablo St
Ste 415
Los Angeles, CA 90033
Phone (323) 442-5843

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1520 San Pablo St
Ste 1000
Los Angeles, CA 90033
Phone (626) 457-5839

1355 San Pablo St
Los Angeles, CA 90033
Phone (626) 457-5800

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871529248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900311309",
            "telephone_number": "323-442-5100",
            "fax_number": "323-442-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "SUITE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5100",
            "fax_number": "323-442-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADIM",
        "first_name": "MITRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A63716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mitra.nadim@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "address_2": "SUITE 1000",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.