Individual provider Active NPI

Rajiv J Pathak, M.D.

  • Internal Medicine Physician
  • Dana Point, CA
National Provider Identifier
1265528111
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C143677 Issued in CA
Practice address
32585 Golden Lantern St Ste E
Dana Point, CA 92629-3252
Phone
(949) 240-2555
Fax
(949) 240-2121
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA59128 NJ
Internal Medicine Physician 207R00000X C143677 CA Primary

Addresses

Primary practice location

32585 Golden Lantern St Ste E
Dana Point, CA 92629-3252

Mailing address

32585 Golden Lantern St Ste E
Dana Point, CA 92629-3252
Phone (949) 240-2555

Other practice location 1

230 US Highway 206 Bldg 2 Unit 5
Flanders, NJ 07836-9189
Phone (973) 584-9669

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, 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
I20081015000461 NJ Practitioner - Internal Medicine 2860550118
I20240222001073 CA Practitioner - Internal Medicine 2860550118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

32585 Golden Lantern St
Suite E
Dana Point, CA 92629-3252
Phone (949) 240-2555

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions12
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C143677CAMDInternal Medicine Physician
MA59128NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
New Jersey Hope Medical Associates, LLC Internal Medicine Past Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
Hackettstown Communitiy Hospital Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

32585 Golden Lantern
Ste E
Dana Point, CA 92629
Phone (949) 240-2555

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rpathak838740@direct.memorialcare.org
  • Direct secure messaging: rajiv.pathak@medicalassociatesofmtolive.ehi.direct-ci.com

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1265528111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32585 GOLDEN LANTERN ST STE E",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293252",
            "telephone_number": "949-240-2555",
            "fax_number": "949-240-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32585 GOLDEN LANTERN ST STE E",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293252",
            "telephone_number": "949-240-2555",
            "fax_number": "949-240-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 US Highway 206 Bldg 2 Unit 5",
            "address_purpose": "LOCATION",
            "city": "Flanders",
            "state": "NJ",
            "postal_code": "078369189",
            "country_code": "US",
            "telephone_number": "973-584-9669",
            "fax_number": "973-584-8729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "RAJIV",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA59128",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C143677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

Verify at the official NPI Registry.