Individual provider Active NPI

Roya Vahdatinia

  • Physical Medicine & Rehabilitation Physician
  • Loma Linda, CA
National Provider Identifier
1003313859
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
17738 Issued in CA
Practice address
11234 Anderson St Ste C
Loma Linda, CA 92354-2804
Phone
(909) 558-6202
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 17738 CA Primary

Addresses

Primary practice location

11234 Anderson St Ste C
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-6202

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912002218 CA Practitioner - Physical Medicine and Rehabilitation 8426433434 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehab Consultants California Inc Physical Medicine & Rehabilitation CurrentSince Jul 1, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 26, 2023 Accepting new patients
Integrative Sports and Spine Inc CurrentSince Aug 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 26, 2023 Accepting new patients

Locations

1130 W La Palma Ave
Anaheim, CA 92801
Phone (714) 772-7480

1609 Trousdale Dr
Burlingame, CA 94010
Phone (530) 400-3060

7777 Sunrise Blvd
Ste 2500
Citrus Hts, CA 95610
Phone (562) 997-2171

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

9080 Irvine Center Dr
Irvine, CA 92618
Phone (949) 540-5641

7160 Fay Ave
La Jolla, CA 92037
Phone (858) 459-4361

1501 Skyline Dr
Monterey, CA 93940
Phone (831) 200-9651

5225 S J St
Oxnard, CA 93033
Phone (805) 488-3696

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

7716 W Manchester Ave
Playa del Rey, CA 90293
Phone (310) 823-4694

1618 Laurel Ave
Redlands, CA 92373
Phone (909) 792-6050

1155 E Springfield Ave
Reedley, CA 93654
Phone (559) 638-9225

3688 Nye Ave
Riverside, CA 92505
Phone (951) 351-2800

1161 Cirby Way
Roseville, CA 95661
Phone (916) 782-1238

2240 Northrop Ave
Sacramento, CA 95825
Phone (858) 247-0691

1150 Tilton Dr
Sunnyvale, CA 94087
Phone (408) 735-2700

275 Garnet Way
Upland, CA 91786
Phone (909) 449-4887

4444 W Meadow Ave
Visalia, CA 93277
Phone (559) 251-8463

1224 Rossmoor Pkwy
Walnut Creek, CA 94595
Phone (925) 937-7450

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1003313859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST STE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHDATINIA",
        "first_name": "ROYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-09-26",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "17738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.