Individual provider Active NPI

Tariq Mahmood, M.D.

  • Hematology & Oncology Physician
  • Orange, CA
National Provider Identifier
1104874171
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A34660 Issued in CA
Practice address
1010 W la Veta Ave Ste 250
Orange, CA 92868-4303
Phone
(714) 541-6622
Fax
(714) 541-0531
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A34660 CA
Hematology & Oncology Physician 207RH0003X A34660 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave Ste 250
Orange, CA 92868-4303

Mailing address

1010 W la Veta Ave Ste 250
Orange, CA 92868-4303
Phone (714) 541-6622

Other identifiers 2

IdentifierTypeStateIssuer
GR0057460MedicaidCA
WA34660BOtherPTAN

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
I20090121000563 CA Practitioner - Hematology/Oncology 1254390875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1010 W la Veta Ave
Suite 200
Orange, CA 92868-4301
Phone (714) 835-1800

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 633-1011

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34660CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
BMS Physician Practice Current Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2023 Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St. Joseph Hospital Specialist Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

1010 W La Veta Ave
Ste 250
Orange, CA 92868
Phone (714) 541-6622

1010 W La Veta Ave
Ste 200
Orange, CA 92868
Phone (714) 835-1800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tmahmood1372922@oc.providencedirect.org

Organizations & group practices 8

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 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1104874171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684303",
            "telephone_number": "714-541-6622",
            "fax_number": "714-541-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE STE 250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684303",
            "telephone_number": "714-541-6622",
            "fax_number": "714-541-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "TARIQ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A34660",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A34660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "WA34660B",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.