Individual provider Active NPI

Masoud Vazirnezami

  • Audiologist-Hearing Aid Fitter
  • La Jolla, CA
National Provider Identifier
1902069404
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU2716 Issued in CA
Practice address
4130 La Jolla Village Dr
Ste 208
La Jolla, CA 92037-9121
Phone
(858) 678-0081
Fax
(858) 678-8580
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU2716 CA Primary

Addresses

Primary practice location

4130 La Jolla Village Dr
Ste 208
La Jolla, CA 92037-9121

Mailing address

4130 La Jolla Village Dr
Ste 107
La Jolla, CA 92037-8402
Phone (619) 734-8877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705003073 AZ Practitioner - Qualified Audiologist 3779646385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2680 S Ave B
Yuma, AZ 85364-6901
Phone (928) 336-1476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU2716CAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince May 24, 2023 Accepting new patients
Yuma Regional Medical Center CurrentSince May 24, 2023 Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter PastSince Dec 28, 2022 Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter PastSince Dec 16, 2020 Accepting new patients
Connect Hearing, Inc. Audiologist-Hearing Aid Fitter Past Accepting new patients
American Hearing Aid Center of the South Bay, Inc Audiologist-Hearing Aid Fitter PastSince Oct 31, 2021 Accepting new patients

Locations

2680 S Avenue B
Yuma, AZ 85364
Phone (928) 336-1476

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Organizations & group practices 9

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1902069404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 LA JOLLA VILLAGE DR",
            "address_2": "STE 107",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378402",
            "telephone_number": "619-734-8877",
            "fax_number": "978-313-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 LA JOLLA VILLAGE DR",
            "address_2": "STE 208",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379121",
            "telephone_number": "858-678-0081",
            "fax_number": "858-678-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZIRNEZAMI",
        "first_name": "MASOUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU2716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.