Maziyar Amini, M.D.
Individual provider Active NPI Internal Medicine Physician · Los Angeles, CA
NPI 1891992525 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1891992525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A100096 (CA)
- Practice address
- 1200 N State St
Los Angeles, CA 90033-1029 - Phone
- (323) 226-7556
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Gastroenterology
- Education
- Vanderbilt University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
615 W Ave L
Lancaster, CA 93534-7211
Phone (661) 729-7100
Hospital & facility affiliations
- Antelope Valley Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110927000234 | CA | Practitioner - Gastroenterology |
3577734383 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A100096 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A100096 | CA | Yes |
Addresses
Primary practice location
1200 N State St
Los Angeles, CA 90033-1029
Mailing address
14631 Dickens St
#19
Sherman Oaks, CA 91403-5214
Phone (818) 357-7989
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Los Angeles, CA
- Sonal Amin
- Suchi Jatin Amin
- Ali Amini
- Erin Amini
- Maziar Mitchel Amini
- Nanaz F Amini
- Nazanin Amini
- Nelly Amini
- Nima Amini
- Sahar Amini
All providers in Los Angeles, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. 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.