Individual provider Active NPI

Maryam Dadfarnia Ameri, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Duarte, CA
National Provider Identifier
1871811091
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A125553 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(626) 256-4673
NPI assigned
May 12, 2010
Last updated
Jul 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A125553 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

1333 S Mayflower Ave
FL 2
Monrovia, CA 91016-4066
Phone (626) 775-3514

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
I20130612000663 CA Practitioner - Pathology 2860631348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Pathology Medical GroupGroup PAC ID 9537313028, 7 clinicians

Practice addresses (Care Compare)

1805 Medical Ctr Dr
San Bernardino, CA 92411-1217
Phone (909) 887-6333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125553CAMDCounselor
A125553CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Jun 1, 2013 Accepting new patients
Reda M Tadros MD Inc Anatomic Pathology & Clinical Pathology Current Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2013 Accepting new patients
High Desert Pathology Medical Group Anatomic Pathology & Clinical Pathology CurrentSince Sep 10, 2017 Accepting new patients
County of Los Angeles Current Accepting new patients
California Cancer Specialists Medical Group Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

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 1

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1871811091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE",
            "address_2": "FL 2",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164066",
            "telephone_number": "626-775-3514",
            "fax_number": "626-408-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMERI",
        "first_name": "MARYAM",
        "middle_name": "DADFARNIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A125553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.