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LEILA MAHDAVIAN M.D.
NPI 1689094153
General Practice in Bronx, NY

Active since April 23, 2014PECOS EnrolledAccepts Medicare Assignment
1010 UNDERHILL AVE, BRONX, NY 10472(718) 299-7295(718) 299-6797 Get Directions Write a Review

NPPES record last updated: May 26, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 26, 2023, Jan 17, 2017, Dec 27, 2016 (3 updates tracked since 2016).

About Leila Mahdavian M.d. NPPES

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

LEILA MAHDAVIAN M.D. (NPI 1689094153) is an individual general practice provider in Bronx, New York, licensed in New York (PO1992) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1689094153
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameLEILA MAHDAVIANCredential: M.D.
Location Address1010 UNDERHILL AVEBronx, NY 10472-6012
Mailing Address3198 Grand ConcourseBronx, NY 10458-1000 · (718) 618-0401 · Fax (718) 795-4394
Phone(718) 299-7295
Fax(718) 299-6797
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateApril 23, 2014
Last NPPES UpdateMay 26, 20233 updates tracked since enumeration
✔ NPI 1689094153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in NY · PO1992
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1010 UNDERHILL AVE, Bronx, NY 10472
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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

Leila Mahdavian M.d. 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.

PECOS PAC ID2769841345
PECOS Enrollment IDI20230629001383
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 Leila Mahdavian reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
2,435 mi
Health Maintenance Organization
4647 ZION AVE
San Diego, CA 92120
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1225060742 (619) 528-5000

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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIMIR ABRAR MD
Physical Medicine & Rehabilitation
1010 UNDERHILL AVE
BRONX, NY 10472
Bronx County (872) 231-3162
BRONX CENTER FOR REHABILITATION AND HEALTH CARE
Skilled Nursing Facility
1010 UNDERHILL AVE
BRONX, NY 10472
Bronx County (718) 863-6700
NARINE SALOMONE RN
Registered Nurse
1010 UNDERHILL AVE
BRONX, NY 10472
Bronx County (718) 863-6700
BRONX CENTER FOR RENAL DIALYSIS LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1010 UNDERHILL AVE
BRONX, NY 10472
Bronx County (718) 863-6700

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 Leila Mahdavian's NPI number?

The NPI number for Leila Mahdavian is 1689094153. It was assigned to this individual provider in the NPPES registry on April 23, 2014.

Where is Leila Mahdavian located?

Leila Mahdavian practices at 1010 Underhill Ave, Bronx, NY 10472. The listed phone number is (718) 299-7295.

What is Leila Mahdavian's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Leila Mahdavian enrolled in Medicare?

Yes. Leila Mahdavian 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 Leila Mahdavian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leila Mahdavian reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, 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 Leila Mahdavian'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 Leila Mahdavian was last updated on May 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.