Sam A Ebrahimi, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Tarzana, California. He went to University Of California, Geffen School Of Medicine and graduated in 1996 and has 28 years of diverse experience with area of expertise as Vascular Surgery. His current practice location is
18375 Ventura Blvd, Suite# 404, Tarzana, California. You can reach out to his office (for appointments etc.) via phone at
(818) 422-5322.
Sam A Ebrahimi is licensed to practice in California (license number A060777) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1114916376.
Physician's Profile
| Full Name | Sam A Ebrahimi |
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| Gender | Male |
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| Speciality | Vascular Surgery |
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| Experience | 28 Years |
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| Location | 18375 Ventura Blvd, Tarzana, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Sam A Ebrahimi attended and graduated from University Of California, Geffen School Of Medicine in 1996
NPI Data:
- NPI Number: 1114916376
- Provider Enumeration Date: 10/19/2005
- Last Update Date: 10/23/2016
Medicare PECOS Information:
- PECOS PAC ID: 2668425018
- Enrollment ID: I20100716000509
Medical Identifiers
Medical identifiers for Sam A Ebrahimi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114916376 | NPI | - | NPPES |
| 100336 | Other | | JHHC PRIORITY PARTNER |
| J449-0010 | Other | DC | CAREFIRST |
| 035556900 | Medicaid | DC | |
| 4129526 | Other | | MAMSI LIFE & HEALTH |
| 484AWA | Other | MD | CAREFIRST MARYLAND |
| P00435744 | Other | DC | RAILROAD MEDICARE |
| 404465702 | Medicaid | MD | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2086S0129X | Surgery - Vascular Surgery | MD33806 (District Of Columbia) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 0101233742 (Virginia) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | D0059318 (Maryland) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | A060777 (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. Sam A Ebrahimi allows following entities to bill medicare on his behalf.
| Entity Name | California Institute For Cardiovascular And Laser Vein Surg |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891092797
PECOS PAC ID: 0941486906
Enrollment ID: O20110510000081 |
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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. Sam A Ebrahimi 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 |
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Sam A Ebrahimi, MD
18375 Ventura Blvd, Suite# 404,
Tarzana, CA 91356-4218
Ph: (301) 537-7751 | Sam A Ebrahimi, MD
18375 Ventura Blvd, Suite# 404,
Tarzana, CA 91356-4218
Ph: (818) 422-5322 |
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