Individual provider Active NPI

Ali Ghorbanifarajzadeh, DPM

  • Primary Podiatric Medicine Podiatrist
  • Bakersfield, CA
National Provider Identifier
1164824249
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
E5332 Issued in CA
Practice address
500 Old River Rd Ste 185
Bakersfield, CA 93311-9505
Phone
(661) 832-3600
Fax
(661) 322-6249
NPI assigned
Sep 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E5332 CA
Primary Podiatric Medicine Podiatrist 213EP1101X E5332 CA Primary

Addresses

Primary practice location

500 Old River Rd Ste 185
Bakersfield, CA 93311-9505

Mailing address

11325 Park Square Dr Apt D204
Bakersfield, CA 93311-8854
Phone (305) 310-8155

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011003626 CA Practitioner - Podiatry 0244505568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1665 S Imperial Ave
Suite a
El Centro, CA 92243-4247
Phone (442) 250-1250

Hospital & facility affiliations

  • Uni Care Home Care Inc Home health agency, El Centro, CA, CCN 057415
  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045
  • Pioneers Memorial Healthcare District Hospital, Brawley, CA, CCN 050342

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue490
Removal of skin lesions16
Removal of nail tissue811
Removal or shaving of skin growth229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5332CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central California Leg, Foot, and Ankle Center, Inc. Foot & Ankle Surgery CurrentSince Dec 16, 2020 Accepting new patients
Central California Leg, Foot, and Ankle Center, Inc. Primary Podiatric Medicine CurrentSince Feb 23, 2020 Accepting new patients
University Foot and Ankle Institute a Podiatric Surgical Center Primary Podiatric Medicine Past Accepting new patients

Locations

1073 Ross Ave
Ste D
El Centro, CA 92243
Phone (760) 340-1003

1665 S Imperial Ave
Ste A
El Centro, CA 92243
Phone (305) 310-8155

27462 Portola Pkwy
Ste 100
Lake Forest, CA 92610
Phone (949) 280-6497

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJEDCD/Endpoint/GJEDCD

Organizations & group practices 3

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.

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": "1411257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1164824249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11325 PARK SQUARE DR APT D204",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933118854",
            "telephone_number": "305-310-8155",
            "fax_number": "661-322-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OLD RIVER RD STE 185",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119505",
            "telephone_number": "661-832-3600",
            "fax_number": "661-322-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHORBANIFARAJZADEH",
        "first_name": "ALI",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-21",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5332",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E5332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.