Individual provider Active NPI

Fazlollah Behzad Kasravi, M.D.

  • Internal Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1164727251
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
115332 Issued in CA
Practice address
1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Phone
(925) 947-3393
Fax
(925) 947-3396
NPI assigned
Jan 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 115332 CA Primary

Addresses

Primary practice location

1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501

Mailing address

PO Box 9017
Walnut Creek, CA 94598-0917
Phone (925) 952-2828

Other identifiers 1

IdentifierTypeStateIssuer
1164727251MedicaidCA

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
I20110624000030 CA Practitioner - Internal Medicine 3577741495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orohealth Corporation a Non Profit Healthcare SystemGroup PAC ID 4082501192, 126 clinicians

Practice addresses (Care Compare)

2767 Olice Hwy
Oroville, CA 95966-6118

2767 Olive Hwy
Oroville, CA 95966-6118

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.23 of 100Reported as group
Quality
36.36
Promoting interoperability
100
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115332CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System Internal Medicine CurrentSince May 1, 2013 Accepting new patients
Hospitalist Medicine Physicians of San Luis Obispo County, Inc Internal Medicine Past Accepting new patients

Locations

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2760 Oro Dam Blvd E
Ste A
Oroville, CA 95966
Phone (530) 534-0601

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

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": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1164727251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9017",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945980917",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952501",
            "telephone_number": "925-947-3393",
            "fax_number": "925-947-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASRAVI",
        "first_name": "FAZLOLLAH",
        "middle_name": "BEHZAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-20",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "115332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164727251",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.