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SAMUEL SIMON DAVID KIANMAHD MD
NPI 1376122390
Student in an Organized Health Care Education/Training Program in Downey, CA

Active since April 06, 2021PECOS Enrolled
11500 BROOKSHIRE AVE, GME OFFICE DOWNEY, DOWNEY, CA 90241(562) 904-5000 Get Directions Write a Review

NPPES record last updated: April 6, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Samuel Simon David Kianmahd Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL SIMON DAVID KIANMAHD MD (NPI 1376122390) is an individual student in an organized health care education/training program in Downey, California and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1376122390
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSAMUEL SIMON DAVID KIANMAHDCredential: MD
Location Address11500 BROOKSHIRE AVE, GME OFFICE DOWNEYDowney, CA 90241-4917
Mailing Address11500 Brookshire Ave, Gme Office DowneyDowney, CA 90241-4917 · (562) 904-5000
Phone(562) 904-5000
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 6, 2021
NPPES CertifiedApril 6, 2021
✔ NPI 1376122390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11500 BROOKSHIRE AVE, Downey, CA 90241
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Simon David Kianmahd Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123525094
PECOS Enrollment IDI20251007003959
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Kianmahd reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Access For All, Inc
4.1 mi
Dental
4750 GAGE AVENUE
Bell, CA 90201
  • Reassigned Medicare billing, California enrollment
  • 12 clinicians in this Medicare group
NPI 1356068829 (323) 562-1100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

ANDREW SALEEB
Student in an Organized Health Care Education/Training Program
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5000
CALIFORNIA EM-I MEDICAL SERVICES, A MEDICAL CORPORATION
Emergency Medicine
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (469) 401-3286
MANDAAR GOKHALE MD
Emergency Medicine
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5000
AVA AZIMI M.D.
Internal Medicine
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5000
VIVIAN TO DO
Hospitalist
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5000
DAVID ROGERS GARVER M.D.
Anesthesiology
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (560) 904-5000
KEVIN OEI
Family Medicine
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5000
DR. ELIZABETH FRANCES GIBBS DO
Family Medicine
11500 BROOKSHIRE AVE
DOWNEY, CA 90241
Los Angeles County (562) 904-5482

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 Samuel Kianmahd's NPI number?

The NPI number for Samuel Kianmahd is 1376122390. It was assigned to this individual provider in the NPPES registry on April 6, 2021.

Where is Samuel Kianmahd located?

Samuel Kianmahd practices at 11500 Brookshire Ave Gme Office Downey, Downey, CA 90241. The listed phone number is (562) 904-5000.

What is Samuel Kianmahd's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Samuel Kianmahd enrolled in Medicare?

Yes. Samuel Kianmahd is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samuel Kianmahd's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Kianmahd reassigns Medicare benefits to Health Access For All, Inc (Bell, 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 Samuel Kianmahd'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 Samuel Kianmahd was last updated on April 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.