RENAISSANCE ASTHETIC LASER AND VEIN INSTITUTE, A MEDICAL CORPORATION
NPI 1730258187
Surgery - Vascular Surgery in Thousand Oaks, CA
About Renaissance Asthetic Laser And Vein Institute, A Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RENAISSANCE ASTHETIC LASER AND VEIN INSTITUTE, A MEDICAL CORPORATION (NPI 1730258187) is a healthcare organization registered as a vascular surgery in Thousand Oaks, California and active in the NPI registry since November 2006. The organization lists Gholam Reza Mohammadzadeh, Owner/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Renaissance Asthetic Laser And Vein Institute, A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Renaissance Asthetic Laser And Vein Institute, A Medical Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Thousand Oaks, CA 91361
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Renaissance Asthetic Laser And Vein Institute, A Medical Corporation's NPI number?
The NPI number for Renaissance Asthetic Laser And Vein Institute, A Medical Corporation is 1730258187. It was assigned to this organization in the NPPES registry on November 7, 2006.
Where is Renaissance Asthetic Laser And Vein Institute, A Medical Corporation located?
Renaissance Asthetic Laser And Vein Institute, A Medical Corporation is located at 77 Rolling Oaks Dr Ste 202, Thousand Oaks, CA 91361. The listed phone number is (805) 379-6717.
What is Renaissance Asthetic Laser And Vein Institute, A Medical Corporation's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is Renaissance Asthetic Laser And Vein Institute, A Medical Corporation enrolled in Medicare?
Yes. Renaissance Asthetic Laser And Vein Institute, A Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Renaissance Asthetic Laser And Vein Institute, A Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Cardiac Surgery) reassigns their Medicare billing to Renaissance Asthetic Laser And Vein Institute, A Medical Corporation. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Renaissance Asthetic Laser And Vein Institute, A Medical Corporation was last updated on August 23, 2024. 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.
# Renaissance Asthetic Laser And Vein Institute, A Medical Corporation · NPI 1730258187
Vascular Surgery organization in Thousand Oaks, California. Organization record, active in the CMS NPPES registry since November 7, 2006.
## Identity
- **NPI:** 1730258187 (Entity type: Organization)
- **Enumerated:** November 7, 2006
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **Organization subpart:** No
- **Authorized official:** Gholam Mohammadzadeh, OWNER/PRESIDENT
## Practice location
- **Address:** 77 ROLLING OAKS DR STE 202, Thousand Oaks, CA 91361-1018
- **Phone:** (805) 379-6717
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Cardiac Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1730258187) · Data from the CMS NPPES public registry.