MARYAM POURJALIL NP
NPI 1114791910
Nurse Practitioner - Family in Tarzana, CA
About Maryam Pourjalil Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARYAM POURJALIL NP (NPI 1114791910) is an individual family provider in Tarzana, California, licensed in California (95028015) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Maryam Pourjalil Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Maryam Pourjalil reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Encino, CA 91436
- Reassigned Medicare billing, California enrollment
- 13 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91356 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Maryam Pourjalil's NPI number?
The NPI number for Maryam Pourjalil is 1114791910. It was assigned to this individual provider in the NPPES registry on November 13, 2023.
Where is Maryam Pourjalil located?
Maryam Pourjalil practices at 18321 Clark St, Tarzana, CA 91356. The listed phone number is (310) 567-9229.
What is Maryam Pourjalil's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Maryam Pourjalil enrolled in Medicare?
Yes. Maryam Pourjalil is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Maryam Pourjalil's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maryam Pourjalil reassigns Medicare benefits to Mordo Suchov MD Inc (Encino, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maryam Pourjalil's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Maryam Pourjalil was last updated on November 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Maryam Pourjalil, NP · NPI 1114791910
Family physician in Tarzana, California. Individual provider, active in the CMS NPPES registry since November 13, 2023.
## Identity
- **NPI:** 1114791910 (Entity type: Individual)
- **Enumerated:** November 13, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95028015 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 18321 CLARK ST, Tarzana, CA 91356-3501
- **Phone:** (310) 567-9229
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mordo Suchov MD Inc (NPI 1306073994, Encino, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** November 13, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1114791910) · Data from the CMS NPPES public registry.