Individual provider Active NPI

Payam Daneshrad, MD

  • Otolaryngology Physician
  • Santa Monica, CA
National Provider Identifier
1902959307
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A71327 Issued in CA
Practice address
2811 Wilshire Blvd
Suite 800
Santa Monica, CA 90403
Phone
(310) 306-3737
Fax
(310) 306-1240
NPI assigned
Jan 19, 2007
Last updated
Jun 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A71327 CA Primary

Addresses

Primary practice location

2811 Wilshire Blvd
Suite 800
Santa Monica, CA 90403

Mailing address

2811 Wilshire Blvd
Suite 800
Santa Monica, CA 90403
Phone (310) 306-3739

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
I20040420001850 CA Practitioner - Otolaryngology 2567458235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tulane University School of Medicine, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1304 15TH St
Suite 407
Santa Monica, CA 90404-1813
Phone (310) 453-6500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71327CAMDPharmacist
A71327CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Providers of California Medical Group, Inc Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Cedars Towers Surgical Medical Group PastSince Apr 6, 2021 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIEIAA/Endpoint/JIEIAA

Organizations & group practices 5

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1902959307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 800",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-306-3739",
            "fax_number": "310-306-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 800",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-306-3737",
            "fax_number": "310-306-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANESHRAD",
        "first_name": "PAYAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A71327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.