NPIMap

Individual provider Active NPI

Abdul Wasay Raif Jawid, M.D

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1245672815
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A140424 Issued in CA
Practice address
1401 E 31St St
Oakland, CA 94602
Phone
(510) 347-4141
NPI assigned
Jul 24, 2013
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A140424 CA Primary

Addresses

Primary practice location

1401 E 31St St
Oakland, CA 94602

Mailing address

1901 W Kettleman LN
Lodi, CA 95242-4337
Phone (209) 334-8540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160920000719 CA Practitioner - Internal Medicine 8426347360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1031 S Fairmont Ave
Lodi, CA 95240-5112
Phone (209) 334-8580

1524 W Lacey Blvd
Suite 101
Hanford, CA 93230-5990
Phone (559) 583-4695

515 S Fairmont Ave
Lodi, CA 95240-3834
Phone (209) 334-8570

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140424CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Multi-Specialty Current Accepting new patients
Adventist Health Physicians Network CurrentSince Oct 1, 2020 Accepting new patients
Lodi Memorial Hospital Association Inc Multi-Specialty CurrentSince Jun 15, 2018 Accepting new patients
Lodi Memorial Hospital Association Inc Multi-Specialty CurrentSince Jun 15, 2018 Accepting new patients
Adventist Health Physicians Network Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
Lodi Memorial Hospital Association, Inc Multi-Specialty Current Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients

Locations

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

1901 W Kettleman Ln
Ste 200
Lodi, CA 95242
Phone (209) 334-8540

2415 W Vine St
Ste 105
Lodi, CA 95242
Phone (209) 333-3121

801 S Ham Ln
Ste S
Lodi, CA 95242
Phone (209) 333-8066

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1245672815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "209-334-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94602",
            "telephone_number": "510-347-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIF JAWID",
        "first_name": "ABDUL",
        "middle_name": "WASAY",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A140424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.