Organization Active NPI

Afrouz Gerayli MD Inc

  • Internal Medicine Physician
  • Camarillo, CA
National Provider Identifier
1295828259
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AFROUZ GERAYLI MD INC
Practice address
500 Paseo Camarillo
#100
Camarillo, CA 93010-5900
Phone
(805) 484-1033
Fax
(805) 482-7213
NPI assigned
Oct 2, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Afouz S Gerayli, MD
Title
President
Phone
(805) 484-1033

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0996763Afrouz Gerayli MD500 Paseo Camarillo Ste 100, Camarillo, CA 93010Certificate of waiverFeb 25, 2028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120206000900 CA Part B Supplier - Clinic/Group Practice 8527225309 Receives reassigned benefits from 3 practitioners
Practice locations: Camarillo, CA

National Provider Directory

National Provider Directory

Locations

335 N A St
Oxnard, CA 93030

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

500 Paseo Camarillo
#100
Camarillo, CA 93010-5900

Mailing address

500 Paseo Camarillo
#100
Camarillo, CA 93010-5900
Phone (805) 484-1033

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00A703600MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 21, 2010.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1295828259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PASEO CAMARILLO",
            "address_2": "#100",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105900",
            "telephone_number": "805-484-1033",
            "fax_number": "805-482-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PASEO CAMARILLO",
            "address_2": "#100",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105900",
            "telephone_number": "805-484-1033",
            "fax_number": "805-482-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFROUZ GERAYLI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "GERAYLI",
        "authorized_official_first_name": "AFOUZ",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-484-1033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A703600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.