NPIMap

Individual provider Active NPI

Rezner H Abubakar

  • Family Medicine Physician
  • La Quinta, CA
National Provider Identifier
1356548648
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C193231 Issued in CA
Practice address
45280 Seeley Dr
La Quinta, CA 92253-6834
Phone
(760) 610-7300
Fax
(760) 610-7301
NPI assigned
Jun 29, 2007
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C193231 CA Primary

Addresses

Primary practice location

45280 Seeley Dr
La Quinta, CA 92253-6834

Mailing address

45280 Seeley Dr
La Quinta, CA 92253-6834
Phone (760) 610-7300

Other practice location 1

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911

Other identifiers 2

IdentifierTypeStateIssuer
102497853MedicaidPA
2021728MedicaidWA

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
I20240621003355 CA Practitioner - Family Practice 6103941646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39950 Vista del Sol
Rancho Mirage, CA 92270-3206
Phone (760) 340-0053

45280 Seeley Dr
La Quinta, CA 92253-6834
Phone (760) 610-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C193231CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center Current Accepting new patients
Eisenhower Medical Center CurrentSince Apr 29, 2024 Accepting new patients
Eisenhower Medical Center CurrentSince Apr 29, 2024 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients
Reading Hospital Family Medicine Past Accepting new patients

Locations

45280 Seeley Dr
La Quinta, CA 92253
Phone (760) 834-3593

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

Interoperability endpoints

  • Direct secure messaging: rabubakar130174@edirect.emc.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1356548648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45280 SEELEY DR",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922536834",
            "telephone_number": "760-610-7300",
            "fax_number": "760-610-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45280 SEELEY DR",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922536834",
            "telephone_number": "760-610-7300",
            "fax_number": "760-610-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39000 Bob Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922703221",
            "country_code": "US",
            "telephone_number": "760-340-3911",
            "fax_number": "760-610-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABUBAKAR",
        "first_name": "REZNER",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C193231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102497853",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021728",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

Verify at the official NPI Registry.