Modern DME LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MODERN DME LLC

Practice address

19652 Ventura Blvd
Tarzana, CA 91356-2970

Phone

(818) 514-6484

Fax

(818) 514-6448

NPI assigned

Feb 16, 2022

Organization subpart

No

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

Authorized official

Name

Hamed Shooreshi

Title

Member

Phone

(818) 518-7726

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726876800000",
    "number": "1942955042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19652 VENTURA BLVD",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562970",
            "telephone_number": "818-514-6484",
            "fax_number": "818-514-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19652 VENTURA BLVD",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562970",
            "telephone_number": "818-514-6484",
            "fax_number": "818-514-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "SHOORESHI",
        "authorized_official_first_name": "HAMED",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "818-518-7726"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimi Yurika Mizumoto, DPT
• John Mlady-Fletcher
• Narine Mnatsakanyan
• Mobile Medical Providers, Inc.
• Michael Mocadam, PHARM D
• Mary Margaret Moebius, MD
• Mohsen Tanbakoochi Moghaddam, M.D.
• Mohammad Abuzaineh MD Inc a Professional Corporation
• Jasmine Molett, BEHAVIORAL THERAPIST
• Jennifer Molina

• Durable Medical Equipment & Medical Supplies in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; 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.