NPIMap

Individual provider Active NPI

Habib Azad, M.D.

  • Nephrology Physician
  • Mission Viejo, CA
National Provider Identifier
1114962610
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G81238 Issued in CA
Practice address
26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384
Phone
(949) 364-0644
Fax
(949) 364-1520
NPI assigned
Jun 18, 2006
Last updated
Oct 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 11824 NV
Nephrology Physician 207RN0300X G81238 CA Primary

Addresses

Primary practice location

26800 Crown Valley Pkwy
Suite 250
Mission Viejo, CA 92691-6384

Mailing address

26522 La Alameda
Suite 120
Mission Viejo, CA 92691-6330
Phone (949) 282-1671

Other identifiers 1

IdentifierTypeStateIssuer
00G812380MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hazad1373932@oc.providencedirect.org

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
I20050603000723 CA Practitioner - NephrologyPractitioner - Internal Medicine 8426091158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Florida College of Medicine, 1993
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)

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

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-8038

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

27799 Medical Ctr Rd
Mission Viejo, CA 92691-6400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81238CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Providence Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Mission Hospital, Inc. Past Accepting new patients
South County Nephrology Consultants Medical Group Inc Nephrology Past Accepting new patients
Regents of Univ of Ca Past Accepting new patients
University of California Irvine Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Kantor Nephrology Consultants, LTD Nephrology 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

279 Imperial Hwy
Ste 730
Fullerton, CA 92835
Phone (714) 449-4841

24411 Health Center Dr
Ste 650
Laguna Hills, CA 92653
Phone (949) 364-0644

22621 Lake Forest Dr
Ste D1
Lake Forest, CA 92630
Phone (949) 242-6902

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26800 Crown Valley Pkwy
Ste 103
Mission Viejo, CA 92691
Phone (949) 347-2822

26800 Crown Valley Pkwy
Ste 250
Mission Viejo, CA 92691
Phone (949) 364-3570

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

27800 Medical Center Rd
Ste 220
Mission Viejo, CA 92691
Phone (949) 364-0644

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: hazad1373932@oc.providencedirect.org

Organizations & group practices 11

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

Hospital & facility affiliations 10

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1114962610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26522 LA ALAMEDA",
            "address_2": "SUITE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916330",
            "telephone_number": "949-282-1671",
            "fax_number": "949-367-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 CROWN VALLEY PKWY",
            "address_2": "SUITE 250",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916384",
            "telephone_number": "949-364-0644",
            "fax_number": "949-364-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAD",
        "first_name": "HABIB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NV",
            "license": "11824",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G81238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G812380",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hazad1373932@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy",
            "address_2": "SUITE 250",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.