Javid Ghandehari, MD is a medicare enrolled "Pain Medicine - Pain Medicine" physician in Santa Monica, California. His current practice location is
2121 Wilshire Blvd Ste 201, Santa Monica, California. You can reach out to his office (for appointments etc.) via phone at
(310) 576-7267.
Javid Ghandehari is licensed to practice in California (license number A127144) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1306002761.
Physician's Profile
| Full Name | Javid Ghandehari |
|---|
| Gender | Male |
|---|
| Speciality | Pain Medicine - Pain Medicine |
|---|
| Location | 2121 Wilshire Blvd Ste 201, Santa Monica, California |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1306002761
- Provider Enumeration Date: 08/05/2008
- Last Update Date: 10/01/2018
Medicare PECOS Information:
- PECOS PAC ID: 1658594262
- Enrollment ID: I20140529002134
Medical Identifiers
Medical identifiers for Javid Ghandehari such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306002761 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 125054209 (Illinois) | Secondary |
| 207L00000X | Anesthesiology | A127144 (California) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | A127144 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Javid Ghandehari allows following entities to bill medicare on his behalf.
| Entity Name | Bayside Anesthesia Medical Group |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1184668469
PECOS PAC ID: 2466490560
Enrollment ID: O20050419001522 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Javid Ghandehari is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Javid Ghandehari, MD
150 W Civic Center Dr Ste 200,
Sandy, UT 84070-4284
Ph: (888) 854-3822 | Javid Ghandehari, MD
2121 Wilshire Blvd Ste 201,
Santa Monica, CA 90403-5742
Ph: (310) 576-7267 |
Reviews and Comments