NPIMap

Individual provider Active NPI

Reza Vaezeafshar, MD

  • Otolaryngology Physician
  • Emeryville, CA
National Provider Identifier
1285044669
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A144953 Issued in CA
Practice address
5800 Hollis St
Emeryville, CA 94608-2016
Phone
(510) 465-0941
NPI assigned
May 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A144953 CA Primary

Addresses

Primary practice location

5800 Hollis St
Emeryville, CA 94608-2016

Mailing address

5800 Hollis St
Emeryville, CA 94608-2016
Phone (510) 465-0941

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
I20190627002298 CA Practitioner - Otolaryngology 7214261080 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

5800 Hollis St
Emeryville, CA 94608-2016
Phone (510) 806-2100

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144953CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Mar 20, 2024 Accepting new patients
Ear, Nose and Throat Associates of San Mateo County Inc Otolaryngology CurrentSince Aug 1, 2019 Accepting new patients
Stanford Health Care CurrentSince Mar 16, 2020 Accepting new patients
University Healthcare Alliance Otolaryngology CurrentSince Jul 20, 2020 Accepting new patients
Stanford Health Care CurrentSince Mar 16, 2020 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Affinity Medical Group Past Accepting new patients
Sequoia Health Services Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
El Camino Hospital Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

5800 Hollis St
Emeryville, CA 94608
Phone (510) 806-2100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

801 Welch Rd
Palo Alto, CA 94304
Phone (650) 723-5281

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

2506 Samaritan Ct
San Jose, CA 95124
Phone (408) 523-3870

100 S Ellsworth Ave
Ste 308
San Mateo, CA 94401
Phone (650) 344-6896

100A San Pablo Towne Ctr
San Pablo, CA 94806
Phone (510) 237-2802

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: rvaezeafshar455740@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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 10

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1285044669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "510-465-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "510-465-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAEZEAFSHAR",
        "first_name": "REZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A144953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.