NPIMap

Individual provider Active NPI

Syed Jafar Raza, MD

  • Cardiovascular Disease Physician
  • Apple Valley, CA
National Provider Identifier
1275609588
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A52952 Issued in CA
Practice address
15962 Quantico Rd
Apple Valley, CA 92307-1302
Phone
(760) 242-7560
Fax
(760) 242-7563
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X P5121 TX
Interventional Cardiology Physician 207RI0011X P5121 TX
Cardiovascular Disease Physician 207RC0000X A52952 CA Primary

Addresses

Primary practice location

15962 Quantico Rd
Apple Valley, CA 92307-1302

Mailing address

PO Box 2680
Victorville, CA 92393-2680
Phone (760) 242-7560

Other identifiers 1

IdentifierTypeStateIssuer
00A59520MedicaidCA

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
I20040901000485 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0446225734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Syed J Raza MD IncGroup PAC ID 3274508569, 2 clinicians

Practice addresses (Care Compare)

15962 Quantico Rd
Apple Valley, CA 92307-1302
Phone (760) 242-7560

Hospital & facility affiliations

  • Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300
  • Bear Valley Community Hospital Hospital, Big Bear Lake, CA, CCN 051335
  • Desert Valley Hospital Hospital, Victorville, CA, CCN 050709

Merit-based Incentive Payment System (MIPS)

Final score
21.2 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52952CAMDCardiovascular Disease Physician
P5121TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Nuclear, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Syed J Raza MD Inc Cardiovascular Disease CurrentSince Jul 1, 2004 Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

15962 Quantico Rd
Apple Valley, CA 92307
Phone (760) 242-0600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ICIEAA/Endpoint/ICIEAA

Organizations & group practices 5

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 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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1275609588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2680",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923932680",
            "telephone_number": "760-242-7560",
            "fax_number": "760-242-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15962 QUANTICO RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071302",
            "telephone_number": "760-242-7560",
            "fax_number": "760-242-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "SYED",
        "middle_name": "JAFAR",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P5121",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "P5121",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A52952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A59520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.