Active NPI
Larry Lalji Momaya, MD
- Psychiatry Physician
- Newport Beach, CA
National Provider Identifier
1962572263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A77504
- Practice address
- 4019 Westerly Place
Suite 100
Newport Beach, CA 92660 - Phone
- (949) 266-3700
- Fax
- (949) 266-3750
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A77504 | CA | Primary |
| Psychiatry Physician | 2084P0800X | BM7666855 | CA |
Addresses
Primary practice location
4019 Westerly Place
Suite 100
Newport Beach, CA 92660
Mailing address
4019 Westerly Place
Suite 100
Newport Beach, CA 92660
Phone (949) 266-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 28, 2014 through Jan 28, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77504 | CA | MD | Marriage & Family Therapist |
| A77504 | CA | MD | Psychiatry Physician |
| BM7666855 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amen Clinics Inc, Bellevue | Psychiatry | Past | Accepting new patients |
| Amen Clinics, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
- Costa Mesa, CA
- NPI 1568865301
-
- Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
- Tukwila, WA
- NPI 1124149851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962572263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4019 WESTERLY PLACE",
"address_2": "SUITE 100",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-266-3700",
"fax_number": "949-266-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 WESTERLY PLACE",
"address_2": "SUITE 100",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-266-3700",
"fax_number": "949-266-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMAYA",
"first_name": "LARRY",
"middle_name": "LALJI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A77504",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "BM7666855",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.