Mahtab Moshtagh Sisan, MD

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

A173400 Issued in CA

Practice address

19950 Rinaldi St Ste 300
Porter Ranch, CA 91326-4141

Phone

(818) 271-2400

Fax

(818) 271-2401

NPI assigned

Jun 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family PracticeAlso: Sleep Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Merit-based Incentive Payment System (MIPS)

Final score

87.51 of 100Reported as group

Quality

79.37

Promoting interoperability

100

Improvement activities

40

Cost

73.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoshtaghsisan894330@direct.uclahealth.org

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.

• The Regents of the University of California

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566

  Family Medicine

  Medicare reassignment Care Compare group NPD
• The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Regents Univ of Calif Los Angeles

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1952308363
  NPD (past)
• The Regents of the University of California

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1982849105
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Mayo Newhall Memorial Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1982197901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19950 RINALDI ST STE 300",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264141",
            "telephone_number": "818-271-2400",
            "fax_number": "818-271-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25775 McBean Pkwy Ste 215",
            "address_purpose": "LOCATION",
            "city": "Valencia",
            "state": "CA",
            "postal_code": "913553703",
            "country_code": "US",
            "telephone_number": "661-753-5464",
            "fax_number": "661-753-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHTAGH SISAN",
        "first_name": "MAHTAB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173400",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "A173400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Stanley Miller, MD
• Erica Min, PHARMD
• John Mina, M.A., CCC-SLP
• Mindful Play Psychological Corporation
• Miracles in Motion Foundation
• Sam Mubara, MD
• My Hearing Centers, LLC
• Lauren Nakata
• Nilou Namazi
• Nana Barseghian Medical Corporation

• Sleep Medicine (Internal Medicine) Physician in Porter Ranch, CA
• Providers in Porter Ranch, CA by specialty
• Sleep Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.
• 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.