Reda Issa, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

A170817 Issued in CA

Practice address

41900 Winchester Rd Ste 201
Temecula, CA 92590-3426

Phone

(951) 679-0400

Fax

(951) 672-6667

NPI assigned

Mar 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, 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

Specialty

Ophthalmology

Education

New York University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group NPD
• Associated Retina Consultants, LTD.

  • Retina Specialist (Ophthalmology) Physician
  • Phoenix, AZ
  • NPI 1164633160
  Medicare reassignment NPD
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162
  NPD

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1255759981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41900 WINCHESTER RD STE 201",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903426",
            "telephone_number": "951-679-0400",
            "fax_number": "951-672-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41900 WINCHESTER RD STE 201",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903426",
            "telephone_number": "951-679-0400",
            "fax_number": "951-672-6667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 E Glendale Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850205505",
            "country_code": "US",
            "telephone_number": "602-242-4928 x159",
            "fax_number": "602-249-4813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSA",
        "first_name": "REDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2022-11-21",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AZ",
            "license": "55602",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A170817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349311",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellonora Isaac, RN
• Celeste Javira Isas
• Elaina Isbell
• Rilizza Janae Isla
• Sherean Ismail
• Ryan Itoh, MD
• Sarah Iverson, PPS
• Christopher John Ivey, MPT,OCS
• Ivonne Vazquez DDS Inc (Overland Dental Practice)
• Kamryn Izquierdo

• Retina Specialist (Ophthalmology) Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.