SAM AMIRMOAZZAMI, D.C. — NPI 1760824262 (Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation in RESEDA, CA)

CMS-1500 Box 24J / 33a • NPI

1760824262

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

111NR0400X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation

Box 32 Service Location & ZIP+4

18437 SATICOY ST, SUITE 5, RESEDA, CA, 91335-2911

✓ 9-Digit EDI 837 ZIP+4 (91335-2911)

Practice Phone & Referral Fax

(818) 343-8700

Fax: (818) 343-8703

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1760824262 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(3) — Felony Health Care Fraud Conviction — Effective 2024-05-20). Verify before submitting Medicare/Medicaid claims.

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1760824262` (NPI-1 Individual Practitioner)
Provider / Legal Name	SAM AMIRMOAZZAMI, D.C.
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation NUCC Code: `111NR0400X` (Chiropractor, Rehabilitation)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	18437 SATICOY ST, SUITE 5, RESEDA, CA, 91335-2911
Practice Telephone / Fax	Tel: (818) 343-8700 \| Fax: (818) 343-8703
Administrative Mailing Address	18437 SATICOY ST, RESEDA, CA, 91335-2911
Enumeration & Last Sync	Enumerated: 2013-07-24 \| CMS Record Updated: 2013-07-24

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

18437 SATICOY ST, SUITE 5, RESEDA, CA, 91335-2911

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Plain-English Taxonomy & CMS Crosswalk (111NR0400X)

What Does Taxonomy Code 111NR0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111NR0400X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor, Rehabilitation for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SAM AMIRMOAZZAMI, D.C.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111NR0400X` — Chiropractor, Rehabilitation Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation	State: CA \| License: `28300` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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SAM AMIRMOAZZAMI, D.C. (NPI #1760824262)