Individual provider Active NPI

Wadsworth Henderson Murad, D.O.

  • Psychiatry Physician
  • Patton, CA
National Provider Identifier
1316909245
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A5006 Issued in CA
Practice address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone
(909) 425-7679
Fax
(909) 425-6635
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A5006 CA Primary

Addresses

Primary practice location

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Mailing address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679

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
I20040727000652 CA Practitioner - PsychiatryPractitioner - Family Practice 7416927645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Family Practice
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Inlandpsych Redlands IncGroup PAC ID 0749337467, 9 clinicians

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 204
Redlands, CA 92373-4870
Phone (909) 798-1763

701 Highland Springs Ave
Suite 7
Beaumont, CA 92223-2550
Phone (951) 849-7455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006CAMDNutritionist
20A5006CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Inlandpsych Redlands Inc Psychiatry Current Accepting new patients
Inlandpsych Redlands Inc Psychiatry CurrentSince Jul 13, 2009 Accepting new patients
Department of State Hospitals Current Accepting new patients
Neighborhood Medical Clinic of Riverside Psychiatry Past Accepting new patients

Locations

701 Highland Springs Ave
Ste 7
Beaumont, CA 92223
Phone (951) 849-7455

3102 E Highland Ave
Ofc
Patton, CA 92369
Phone (909) 425-7000

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

255 Terracina Blvd
Ste 204
Redlands, CA 92373
Phone (909) 496-1266

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1316909245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURAD",
        "first_name": "WADSWORTH",
        "middle_name": "HENDERSON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A5006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.