Individual provider Active NPI

Hazrat G. Rafah, P.A.

  • Physician Assistant
  • Tracy, CA
National Provider Identifier
1184633976
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18268 Issued in CA
Practice address
388 Glenbriar Cir
Tracy, CA 95377-4144
Phone
(661) 917-8500
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18268 CA Primary

Addresses

Primary practice location

388 Glenbriar Cir
Tracy, CA 95377-4144

Mailing address

388 Glenbriar Cir
Tracy, CA 95377-4144
Phone (661) 917-8500

Other identifiers 1

IdentifierTypeStateIssuer
PA18268OtherCAPA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000359 CA Practitioner - Physician Assistant 8527061969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of AmericaGroup PAC ID 3476813460, 112 clinicians

Practice addresses (Care Compare)

5320 Hwy 49 N
Suite 1 3
Mariposa, CA 95338-9588
Phone (209) 966-2344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18268CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of America CurrentSince Jan 1, 2021 Accepting new patients
Cep America - California CurrentSince Jan 1, 2014 Accepting new patients
Ran Health Services, Inc. CurrentSince Dec 1, 2020 Accepting new patients

Locations

6608 Mercy Ct
Ste B
Fair Oaks, CA 95628
Phone (916) 277-8881

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

489 5th St
Gustine, CA 95322
Phone (209) 854-3728

554 5th St
Gustine, CA 95322
Phone (209) 391-8854

517 Main St
#A
Livingston, CA 95334
Phone (209) 445-2388

5320 State Highway 49 N
Ste 1
Mariposa, CA 95338
Phone (209) 966-2225

5320 State Highway 49 N
Ste 13
Mariposa, CA 95338
Phone (209) 966-2344

733 3rd St
Mc Farland, CA 93250
Phone (661) 792-3097

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184633976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 GLENBRIAR CIR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953774144",
            "telephone_number": "661-917-8500",
            "fax_number": "661-326-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 GLENBRIAR CIR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953774144",
            "telephone_number": "661-917-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAH",
        "first_name": "HAZRAT",
        "middle_name": "G.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA18268",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.