Individual provider Active NPI

Fayegh Vakili, M.D.

  • Orthopaedic Surgery Physician
  • Hawthorne, CA
National Provider Identifier
1184724643
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A39870 Issued in CA
Practice address
4477 W 118TH St
Suite 503
Hawthorne, CA 90250-2255
Phone
(310) 644-3500
Fax
(310) 644-0877
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A39870 CA Primary

Addresses

Primary practice location

4477 W 118TH St
Suite 503
Hawthorne, CA 90250-2255

Mailing address

4477 W 118TH St Ste 405
Hawthorne, CA 90250-2259
Phone (310) 644-3500

Other identifiers 1

IdentifierTypeStateIssuer
954032272OtherCATAX ID NO.

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
I20100830000520 CA Practitioner - Orthopedic Surgery 9032233937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4477 W 118TH St
Suite 405
Hawthorne, CA 90250-2259
Phone (310) 644-3500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A39870CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fayegh Vakili Inc CurrentSince Jun 2, 2010 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients

Locations

4477 W 118th St
Ste 405
Hawthorne, CA 90250
Phone (310) 644-3500

4477 W 118th St
Ste 503
Hawthorne, CA 90250
Phone (310) 644-3500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1184724643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 W 118TH ST STE 405",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502259",
            "telephone_number": "310-644-3500",
            "fax_number": "310-644-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W 118TH ST",
            "address_2": "SUITE 503",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502255",
            "telephone_number": "310-644-3500",
            "fax_number": "310-644-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKILI",
        "first_name": "FAYEGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A39870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID NO.",
            "identifier": "954032272",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.