Individual provider Active NPI

Fuad F Rafidi, MD

  • Specialist
  • Tarzana, CA
National Provider Identifier
1174639074
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A38061 Issued in CA
Practice address
18226 Ventura Boulevard
Suite 102
Tarzana, CA 91356-4246
Phone
(818) 345-6126
Fax
(818) 345-5061
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A38061 CA Primary

Addresses

Primary practice location

18226 Ventura Boulevard
Suite 102
Tarzana, CA 91356-4246

Mailing address

18226 Ventura Boulevard
Suite 102
Tarzana, CA 91356-4246
Phone (818) 345-6126

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
I20051129000664 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 4385664861 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38061CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Valley Vascular Group a Medical Corporation Specialist CurrentSince Jul 1, 1987 Accepting new patients
West Hills Hospital Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

2701 W Alameda Ave
Ste 400
Burbank, CA 91505
Phone (818) 842-4821

23823 Valencia Blvd
Ste 215
Santa Clarita, CA 91355

18226 Ventura Blvd
Ste 102
Tarzana, CA 91356
Phone (818) 905-5904

18840 Ventura Blvd
Ste 100A
Tarzana, CA 91356

23101 Sherman Pl
Ste 302
West Hills, CA 91307
Phone (818) 347-1500

Interoperability endpoints

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

Organizations & group practices 5

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1174639074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18226 VENTURA BOULEVARD",
            "address_2": "SUITE 102",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564246",
            "telephone_number": "818-345-6126",
            "fax_number": "818-345-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18226 VENTURA BOULEVARD",
            "address_2": "SUITE 102",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564246",
            "telephone_number": "818-345-6126",
            "fax_number": "818-345-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFIDI",
        "first_name": "FUAD",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A38061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.