Beheshteh Adabzadeh
Individual provider Active NPI Family Nurse Practitioner · Carson, CA
NPI 1881374106 · NPPES record last updated Jul 20, 2023
Key facts
- NPI
- 1881374106
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95025975 (CA)
- Practice address
- 23247 Main St
Carson, CA 90745-5229 - Phone
- (310) 429-0839
- NPI assigned
- Jul 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18345 Ventura Blvd
Suite 202
Tarzana, CA 91356-4232
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250311002337 | CA | Practitioner - Nurse Practitioner | 9234650854 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95025975 | CA | MD | Family Nurse Practitioner |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adab Health & Wellness LLC | Current | Accepting new patients | |
| RMS Cherubim Health Care Services Inc | Family | Current |
Accepting new patients |
| Alta Cielo Medical Group Inc | Current |
Accepting new patients |
Locations
855 N Lark Ellen Ave
Ste J1
West Covina, CA 91791
Phone (626) 722-4695
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- beheshteh.adabzadeh.1@29786.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95025975 | CA | Yes |
Addresses
Primary practice location
23247 Main St
Carson, CA 90745-5229
Mailing address
23247 Main St
Carson, CA 90745-5229
Phone (310) 429-0839
Other providers in Carson, CA
- Above the Rest Speech Therapy Inc
- Abraham DDS Dental Corp
- Mina Abraham
- Absolute Care Health Providers Inc
- Roman Emmanuel Acebedo
- Ebony Adagun
- Joseph Adams
- Gaurav Addagatla
- Ade Osibamiro MD Inc
- Amanda Aden
All providers in Carson, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.