Individual provider Active NPI

Rashida Bazolo N'Gouamba

  • Gynecology Physician
  • Pasadena, CA
National Provider Identifier
1184726481
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
95982 Issued in CA
Practice address
50 Alessandro PL Ste 430
Pasadena, CA 91105
Phone
(626) 796-9114
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 234013 NY
Gynecology Physician 207VG0400X 95982 CA Primary

Addresses

Primary practice location

50 Alessandro PL Ste 430
Pasadena, CA 91105

Mailing address

50 Alessandro PL Ste 430
Pasadena, CA 91105-3170
Phone (626) 796-9114

Other practice location 1

9120 Atlantic Avenue
Ozone Park, NY 11416
Phone (718) 641-8207

Other identifiers 1

IdentifierTypeStateIssuer
02826319MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061205000183 NY Practitioner - Obstetrics/Gynecology 4183623986 Reassigns benefits to 3 organizations
I20191009000239 CA Practitioner - Obstetrics/Gynecology 4183623986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Yale University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg California PCGroup PAC ID 8729276795, 94 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone (626) 397-5000

Hospital & facility affiliations

  • Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234013NYMDObstetrics & Gynecology Physician
95982CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Apr 5, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Obstetrics & Gynecology CurrentSince Apr 1, 2018 Accepting new patients
TJH Medical Services, P.C. Obstetrics & Gynecology CurrentSince Aug 1, 2006 Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Aug 7, 2019 Accepting new patients
Trustees of Columbia University in the City of New York Obstetrics & Gynecology CurrentSince Apr 5, 2017 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Locations

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

11120 Merrick Blvd
Jamaica, NY 11433
Phone (718) 206-7510

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
Ph 1624
New York, NY 10032
Phone (212) 305-4098

9120 Atlantic Ave
Ozone Park, NY 11416
Phone (718) 322-1580

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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 1

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1184726481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL STE 430",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053170",
            "telephone_number": "626-796-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ALESSANDRO PL STE 430",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91105",
            "telephone_number": "626-796-9114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9120 Atlantic Avenue",
            "address_purpose": "LOCATION",
            "city": "Ozone Park",
            "state": "NY",
            "postal_code": "11416",
            "country_code": "US",
            "telephone_number": "718-641-8207",
            "fax_number": "718-845-5287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "N'GOUAMBA",
        "first_name": "RASHIDA",
        "middle_name": "BAZOLO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "234013",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "95982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02826319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.