Individual provider Active NPI

Ryan Abdul-Haqq

  • Vascular Surgery Physician
  • West Hollywood, CA
National Provider Identifier
1386087864
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A154965 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 652-8132
Fax
(310) 358-9326
NPI assigned
Apr 15, 2013
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Vascular Surgery Physician 2086S0129X A154965 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 967-1780

Other practice location 1

2244 Pine Crest Dr
Vestavia, AL 35216-2110
Phone (205) 934-2006

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
I20190430001489 CA Practitioner - Vascular Surgery 8022258334 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Health CenterGroup PAC ID 4183681810, 4 clinicians
Vascular Surgery AssociatesGroup PAC ID 3072984129, 5 clinicians
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 829-4813

8631 W 3Rd St
Suite 615E
Los Angeles, CA 90048-5910
Phone (310) 652-8132

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-3277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

Merit-based Incentive Payment System (MIPS)

Final score
92.16 of 100Reported as group
Quality
71.79
Promoting interoperability
100
Improvement activities
40
Cost
68.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal228
Leg revascularization (restoring blood flow)152
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154965CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint John's Health Center CurrentSince Feb 4, 2019 Accepting new patients
Vascular Surgery Associates Vascular Surgery CurrentSince Dec 30, 2018 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Feb 15, 2019 Accepting new patients
Vascular Surgery Associates Vascular Surgery CurrentSince Jan 1, 2023 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Feb 15, 2019 Accepting new patients

Locations

8631 W 3rd St
Ste 615E
Los Angeles, CA 90048
Phone (310) 652-8132

1301 20th St
Ste 390
Santa Monica, CA 90404
Phone (310) 453-3568

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rabdulhaqq219391@direct.cshs.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 4

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1386087864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-967-1780",
            "fax_number": "866-991-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-652-8132",
            "fax_number": "310-358-9326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2244 Pine Crest Dr",
            "address_purpose": "LOCATION",
            "city": "Vestavia",
            "state": "AL",
            "postal_code": "352162110",
            "country_code": "US",
            "telephone_number": "205-934-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDUL-HAQQ",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A154965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.