Individual provider Active NPI

Tiffany Maggi-Maidinetti, MD

  • Internal Medicine Physician
  • Sylmar, CA
National Provider Identifier
1962951277
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A164598 Issued in CA
Practice address
14445 Olive View Dr # 2B182
Sylmar, CA 91342-1437
Phone
(747) 210-3205
NPI assigned
Sep 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A164598 CA Primary

Addresses

Primary practice location

14445 Olive View Dr # 2B182
Sylmar, CA 91342-1437

Mailing address

4610 X St
Sacramento, CA 95817-2200
Phone (916) 816-3589

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
I20210809003017 CA Practitioner - Internal Medicine 6305240607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Superior Hospitalist Medical Group IncGroup PAC ID 1456650928, 75 clinicians

Practice addresses (Care Compare)

1680 E 120TH St
Los Angeles, CA 90059-3026
Phone (424) 338-8000

Hospital & facility affiliations

  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164598CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Hospitalist Medical Group Inc Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients

Locations

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

Organizations & group practices 1

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 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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1962951277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172200",
            "telephone_number": "916-816-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR # 2B182",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGI-MAIDINETTI",
        "first_name": "TIFFANY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A164598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.