Individual provider Active NPI

Nahidh W Hasaniya, M.D.PHD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Bernardino, CA
National Provider Identifier
1316973605
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
A51994 Issued in CA
Practice address
401 E Highland Ave Ste 251
San Bernardino, CA 92404-3800
Phone
(909) 882-4605
Fax
(909) 475-2680
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A51994 CA Primary

Addresses

Primary practice location

401 E Highland Ave Ste 251
San Bernardino, CA 92404-3800

Mailing address

3400 Data Dr
Attn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

Other identifiers 1

IdentifierTypeStateIssuer
00A519940MedicaidCA

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
I20040623001641 CA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 9830174663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cal Med Physicians and Surgeons IncGroup PAC ID 4385556687, 34 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3353

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A51994CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cal Med Physicians and Surgeons, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jan 3, 2025 Accepting new patients
Inland Empire Extra Care Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Jan 1, 2014 Accepting new patients
Dr H Faiz and Associates Surgical Clinic Inc Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

Interoperability endpoints

  • Direct secure messaging: nhasaniya7568@direct.llu.edu

Organizations & group practices 3

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1316973605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 251",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043800",
            "telephone_number": "909-882-4605",
            "fax_number": "909-475-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASANIYA",
        "first_name": "NAHIDH",
        "middle_name": "W",
        "credential": "M.D.PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A51994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A519940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.