Individual provider Active NPI

Andrei Radulescu, M.D.,PH.D.

  • Pediatric Surgery Physician
  • Loma Linda, CA
National Provider Identifier
1144547977
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
157673 Issued in CA
Practice address
11175 Campus St Ste 21111
Loma Linda, CA 92350
Phone
(614) 432-3145
NPI assigned
May 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 157673 CA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X 157673 CA Primary

Addresses

Primary practice location

11175 Campus St Ste 21111
Loma Linda, CA 92350

Mailing address

11175 Campus St Ste 21111
Loma Linda, CA 92350-3471
Phone (614) 432-3145

Other practice location 1

395 W 12th Ave Rm 654
Columbus, OH 43210-1267
Phone (614) 293-8704

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
I20180920003549 CA Practitioner - General SurgeryPractitioner - Pediatric Medicine 6305085812 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157673CAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Surgery Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2018 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: aradulescu181657@direct.llu.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1144547977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST STE 21111",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923503471",
            "telephone_number": "614-432-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST STE 21111",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350",
            "telephone_number": "614-432-3145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave Rm 654",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-8704",
            "fax_number": "614-293-4063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADULESCU",
        "first_name": "ANDREI",
        "name_prefix": "Dr.",
        "credential": "M.D.,PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "157673",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "157673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.