Individual provider Active NPI

Rokhsareh Roxanne Tajrishi, M.D.

  • Infectious Disease Physician
  • Corona del Mar, CA
National Provider Identifier
1164701819
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A133047 Issued in CA
Practice address
3334 E Coast Hwy
Suite 570
Corona del Mar, CA 92625-2328
Phone
(714) 903-7767
Fax
(714) 903-7801
NPI assigned
Aug 12, 2011
Last updated
Jun 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X A133047 CA Primary

Addresses

Primary practice location

3334 E Coast Hwy
Suite 570
Corona del Mar, CA 92625-2328

Mailing address

3334 E Coast Hwy
Suite 570
Corona del Mar, CA 92625-2328
Phone (714) 903-7767

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
I20150420000007 CA Practitioner - Infectious Disease 5496073637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (949) 520-0888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133047CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radadvantage a Professional Corporation Diagnostic Radiology Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rtajrishi764573@direct.memorialcare.org

Organizations & group practices 2

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 3

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1164701819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY",
            "address_2": "SUITE 570",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328",
            "telephone_number": "714-903-7767",
            "fax_number": "714-903-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY",
            "address_2": "SUITE 570",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328",
            "telephone_number": "714-903-7767",
            "fax_number": "714-903-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJRISHI",
        "first_name": "ROKHSAREH",
        "middle_name": "ROXANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A133047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

Verify at the official NPI Registry.