Individual provider Active NPI

Farideh Ghasemi, FNP

  • Family Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1023190014
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP16641 Issued in CA
Practice address
11705 Slate Ave
#200
Riverside, CA 92505
Phone
(800) 274-3893
Fax
(951) 359-1999
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16641 CA
Family Nurse Practitioner 363LF0000X NP16641 CA Primary

Addresses

Primary practice location

11705 Slate Ave
#200
Riverside, CA 92505

Mailing address

11705 Slate Ave
#200
Riverside, CA 92505
Phone (800) 274-3893

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100917000124 CA Practitioner - Nurse Practitioner 8628193349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP16641CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. CurrentSince Oct 8, 2014 Accepting new patients
Inland Hospitalists Med GP Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1023190014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 SLATE AVE",
            "address_2": "#200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92505",
            "telephone_number": "800-274-3893",
            "fax_number": "951-359-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 SLATE AVE",
            "address_2": "#200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92505",
            "telephone_number": "800-274-3893",
            "fax_number": "951-359-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASEMI",
        "first_name": "FARIDEH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16641",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP16641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.