Individual provider Active NPI

Yasaman Mohtasebi, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Long Beach, CA
National Provider Identifier
1962687889
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A134195 Issued in CA
Practice address
1868 Pacific Ave
Long Beach, CA 90806-6113
Phone
(562) 595-4718
Fax
(562) 591-7323
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A134195 CA Primary

Addresses

Primary practice location

1868 Pacific Ave
Long Beach, CA 90806-6113

Mailing address

5150 E Pacific Coast Hwy Ste 500
Long Beach, CA 90804-3328
Phone (562) 299-5200

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
I20150914002849 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 3870630908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

1050 Linden Ave
Long Beach, CA 90813-3321
Phone (562) 491-9000

1760 Termino Ave
Long Beach, CA 90804-2169

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 728-5034

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • St Mary Medical Center Hospital, Long Beach, CA, CCN 050191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134195CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners a Medical Group Inc CurrentSince Sep 1, 2015 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Monongahela Valley Hospital Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Jefferson Regional Medical Center Past Accepting new patients
Prohealth Partners a Medical Group Inc Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1760 Termino Ave
Ste 214
Long Beach, CA 90804
Phone (562) 595-4718

5150 E Pacific Coast Hwy
Ste 500
Long Beach, CA 90804
Phone (562) 299-5200

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1962687889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY STE 500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043328",
            "telephone_number": "562-299-5200",
            "fax_number": "562-299-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066113",
            "telephone_number": "562-595-4718",
            "fax_number": "562-591-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHTASEBI",
        "first_name": "YASAMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A134195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.