Individual provider Active NPI

Tanyaradzwa Terrence Chasara, MD

  • Obstetrics Physician
  • Apple Valley, CA
National Provider Identifier
1265052443
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
A198526 Issued in CA
Practice address
18300 US Highway 18
Apple Valley, CA 92307-2206
Phone
(864) 908-3530
NPI assigned
Apr 17, 2020
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X A198526 CA Primary

Addresses

Primary practice location

18300 US Highway 18
Apple Valley, CA 92307-2206

Mailing address

82-68 164TH St
Queens Hospital, Dept of OB/GYN, Attn: Marilyn Johnson
Queens, NY 11432
Phone (214) 609-0439

Other practice location 1

82-68 164th St
Queens Hospital, Dept of OB/GYN, Attn: Marilyn Johnson
Queens, NY 11432
Phone (214) 609-0439

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
I20240926004076 CA Practitioner - Obstetrics/Gynecology 1951832260 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198526CAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. CurrentSince Aug 20, 2024 Accepting new patients
Samir E. Hage, D.O., Inc. Past Accepting new patients

Locations

18300 Outer Highway 18
Apple Valley, CA 92307
Phone (760) 946-8873

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 603-5203

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1265052443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-68 164TH ST",
            "address_2": "QUEENS HOSPITAL, DEPT OF OB/GYN, ATTN: MARILYN JOHNSON",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "214-609-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "864-908-3530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82-68 164th St",
            "address_2": "Queens Hospital, Dept of OB/GYN, Attn: Marilyn Johnson",
            "address_purpose": "LOCATION",
            "city": "Queens",
            "state": "NY",
            "postal_code": "11432",
            "country_code": "US",
            "telephone_number": "214-609-0439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHASARA",
        "first_name": "TANYARADZWA",
        "middle_name": "TERRENCE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-17",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "A198526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.