NPIMap

Individual provider Active NPI

Razi M Arifuddin, MD

  • Gastroenterology Physician
  • Santa Rosa, CA
National Provider Identifier
1124085410
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C56200 Issued in CA
Practice address
500 Doyle Park Dr
Suite G04
Santa Rosa, CA 95405-4558
Phone
(707) 303-8360
Fax
(707) 303-8361
NPI assigned
Apr 28, 2006
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 231776 NY
Gastroenterology Physician 207RG0100X C56200 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr
Suite G04
Santa Rosa, CA 95405-4558

Mailing address

500 Doyle Park Dr
Suite G04
Santa Rosa, CA 95405-4558
Phone (707) 303-8360

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rarifuddin1657443@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
I20140226000445 CA Practitioner - Gastroenterology 1951313402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ukiah Adventist HospitalGroup PAC ID 6406816123, 136 clinicians

Practice addresses (Care Compare)

232 Hospital Dr
Suite B
Ukiah, CA 95482-4562
Phone (707) 463-7356

245 Hospital Dr
Ukiah, CA 95482-4531
Phone (707) 462-3111

275 Hospital Dr
Ukiah, CA 95482-4531
Phone (707) 462-3111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy139
Upper gastrointestinal (GI) endoscopy for acid reflux255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C56200CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince May 21, 2022 Accepting new patients
Ukiah Adventist Hospital CurrentSince Jun 25, 2020 Accepting new patients
Adventist Health Physicians Network CurrentSince May 21, 2022 Accepting new patients
Ukiah Adventist Hospital CurrentSince Jun 25, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Uhs of Texoma, Inc. Past Accepting new patients
Baylor Scott & White Medical Center - Centennial Past Accepting new patients

Locations

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

232 Hospital Dr
Ste B
Ukiah, CA 95482
Phone (707) 463-7356

234 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-0681

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1124085410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE G04",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-303-8360",
            "fax_number": "707-303-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE G04",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-303-8360",
            "fax_number": "707-303-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIFUDDIN",
        "first_name": "RAZI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "231776",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C56200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rarifuddin1657443@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 Doyle Park Dr",
            "address_2": "Suite G04",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.