NPIMap

Individual provider Active NPI

Sami Barham Nazzal, M.D.

  • Interventional Cardiology Physician
  • San Bernardino, CA
National Provider Identifier
1053385575
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A30933 Issued in CA
Practice address
399 E Highland Ave
Suite 307
San Bernardino, CA 92404-3808
Phone
(909) 881-7400
Fax
(909) 881-5217
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X A30933 CA Primary
Cardiovascular Disease Physician 207RC0000X A30933 CA
Internal Medicine Physician 207R00000X A30933 CA

Addresses

Primary practice location

399 E Highland Ave
Suite 307
San Bernardino, CA 92404-3808

Mailing address

399 E Highland Ave
Suite 307
San Bernardino, CA 92404-3808
Phone (909) 881-7400

Other identifiers 1

IdentifierTypeStateIssuer
GR0079880MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081112000855 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9032005889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Empire Cardiovascular Consultants IncGroup PAC ID 8628399102, 6 clinicians

Practice addresses (Care Compare)

6950 Brockton Ave
Suite 1
Riverside, CA 92506-3830
Phone (951) 684-6464

Hospital & facility affiliations

  • St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129
  • Community Hospital of San Bernardino Hospital, San Bernardino, CA, CCN 050089
  • Kaiser Foundation Hospital Fontana/Ontario Hospital, Fontana, CA, CCN 050140
  • Mountains Community Hospital Hospital, Lake Arrowhead, CA, CCN 051312
  • Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
82.33
Improvement activities
40
Cost
79.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30933CAMDChiropractor
A30933CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Empire Cardiovascular Consultants, Inc. Cardiovascular Disease CurrentSince May 1, 2015 Accepting new patients
Anil P Punjabi, MD, DDS, Inc. Past Accepting new patients
Community Memorial Health System Past Accepting new patients
San Bernardino Mountains Community Hospital District Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

10601 Church St
Ste 105
Rch Cucamonga, CA 91730
Phone (909) 989-7100

6950 Brockton Ave
Ste 1
Riverside, CA 92506
Phone (909) 883-8938

374 E Vanderbilt Way
Ste 1
San Bernardino, CA 92408
Phone (909) 686-0038

399 E Highland Ave
Sn Bernrdno, CA 92404
Phone (909) 882-1711

399 E Highland Ave
Ste 307
Sn Bernrdno, CA 92404
Phone (909) 881-7400

374 E Vanderbilt Way
Sn Bernrdno, CA 92408
Phone (909) 280-5557

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 5

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1053385575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE",
            "address_2": "SUITE 307",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-881-7400",
            "fax_number": "909-881-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE",
            "address_2": "SUITE 307",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043808",
            "telephone_number": "909-881-7400",
            "fax_number": "909-881-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZZAL",
        "first_name": "SAMI",
        "middle_name": "BARHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A30933",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A30933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A30933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.