Individual provider Active NPI

Mohammad Mahdi Khoshchehreh Jamalai

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1881057271
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A162927 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-1029
Phone
(310) 267-2680
NPI assigned
Apr 1, 2016
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A162927 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-1029

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8771

Other practice location 1

1200 N State St
Clinic Tower A7D
Los Angeles, CA 90033-1029
Phone (323) 409-7148

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
I20200619000076 CA Practitioner - Pathology 1153743208 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162927CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Jun 1, 2020 Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 16, 2022 Accepting new patients
Alameda Health System CurrentSince Jun 30, 2022 Accepting new patients
Regents of the University of Ca CurrentSince Aug 16, 2022 Accepting new patients
Alameda Health System Current Accepting new patients
County of Los Angeles Current Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

815 Atlantic Ave
Alameda, CA 94501
Phone (510) 535-7363

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

1200 N State St
#A7D
Los Angeles, CA 90089
Phone (323) 226-7556

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4400 V St
Sacramento, CA 95817
Phone (916) 734-2525

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

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

Organizations & group practices 10

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 4

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1881057271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951029",
            "telephone_number": "310-267-2680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N State St",
            "address_2": "Clinic Tower A7D",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "323-409-7148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOSHCHEHREH JAMALAI",
        "first_name": "MOHAMMAD MAHDI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A162927",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.