Asif R. Harsolia, M.D.
Individual provider Active NPI Radiation Oncology Physician · Fountain Valley, CA
NPI 1376565374 · NPPES record last updated Oct 3, 2012
Key facts
- NPI
- 1376565374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiation Oncology Physician 2085R0001X
- License
- A99453 (CA)
- Practice address
- 18111 Brookhurst St
Ste 0300
Fountain Valley, CA 92708-6728 - Phone
- (714) 962-7100
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Radiation Oncology
- Education
- University of Michigan Medical School, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Radiation Oncology Medical
Practice addresses (Care Compare)
18111 Brookhurst St
Ll0300
Fountain Valley, CA 92708-6728
Phone (714) 962-7100
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-0300
Hospital & facility affiliations
- Memorialcare Orange Coast Medical Center
- Memorialcare Long Beach Medical Center
- Hoag Memorial Hospital Presbyterian
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.23 of 100
- Quality
- 69.8
- Improvement activities
- 40
- Cost
- 75.77
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070921000759 | CA | Practitioner - Radiation Oncology | 7012912702 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35670 | AZ | MD | Radiation Oncology Physician |
| A99453 | CA | MD | Radiation Oncology Physician |
Practice roles (11 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Radiation Oncology Medical | Radiation Oncology | Current |
Accepting new patients |
| Memorial Radiation Oncology Medical | Radiation Oncology | Current |
Accepting new patients |
| Saddleback Memorial Medical Center | Past | Accepting new patients | |
| VHS Acquisition Subsidiary Number 1 Inc | Past | Accepting new patients | |
| Long Beach Memorial Medical | Past | Accepting new patients | |
| Honorhealth | Past | Accepting new patients | |
| Orange Coast Memorial Medical Center | Past | Accepting new patients | |
| Long Beach Memorial Medical | Past | Accepting new patients | |
| Arizona Radiation Therapy Management Services Inc | Past | Accepting new patients | |
| Honorhealth | Past | Accepting new patients | |
| Memorial Radiation Oncology Medical | Radiation Oncology | Past | Accepting new patients |
Locations
18111 Brookhurst St
Ste 300
Fountain Valley, CA 92708
Phone (714) 378-7000
18111 Brookhurst St
Ste LL300
Fountain Valley, CA 92708
Phone (714) 962-7100
18111 Brookhurst St
#300
Fountain Vly, CA 92708
Phone (714) 880-8200
24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573
24302 Paseo de Valencia
Laguna Hills, CA 92653
Phone (949) 452-8880
2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- aharsoliamd77249@direct.memorialcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 35670 | AZ | |
| Radiation Oncology Physician | 2085R0001X | A99453 | CA | Yes |
Addresses
Primary practice location
18111 Brookhurst St
Ste 0300
Fountain Valley, CA 92708-6728
Mailing address
2650 Elm Ave
Ste 201
Long Beach, CA 90806-1651
Phone (562) 492-6695
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CR688X | Other | CA | PTAN |
| A99453 | Other | CA | STATE LICENSE |
| 0927400 | Other | AZ | BCBS AZ PROVIDER # |
| 7368874 | Other | AZ | AETNA PROVIDER # |
| 7905964 | Other | AZ | CIGNA PROVIDER # |
| 125097 | Medicaid | AZ | |
| 125097 | Other | AZ | CARE 1ST HLTH. PLAN # |
Other providers in Fountain Valley, CA
- James Bose Hariyanto
- Jacquelyn Harlan
- Diane Barbara Harris
- Christian Michael Harrison
- Deborah P Harrop
- Harvinder S. Sahni, M.D., Inc
- Rafay Ahad Haseeb
- Sarah Z Hassan
- Hisayo Hatakeyama
- Brittany Hatfield
All providers in Fountain Valley, CA · Radiation Oncology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.