Individual provider Active NPI

Nader Magdy Rezkalla, MD

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1386266724
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A185455 Issued in CA
Practice address
1303 E Herndon Ave Ste 850
Fresno, CA 93720-3309
Phone
(559) 450-3000
NPI assigned
May 7, 2020
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 A185455 CA Primary

Addresses

Primary practice location

1303 E Herndon Ave Ste 850
Fresno, CA 93720-3309

Mailing address

1111 E Spruce Ave Ste 431
Fresno, CA 93720-3330
Phone (559) 450-7449

Other practice location 1

940 Northgate Dr
Richland, WA 99352-3505
Phone (509) 942-2516

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
I20230919004229 CA Practitioner - Family Practice 2466874938 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Superior Hospitalist Medical Group IncGroup PAC ID 1456650928, 75 clinicians

Practice addresses (Care Compare)

1680 E 120TH St
Los Angeles, CA 90059-3026
Phone (424) 338-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A185455CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation Family Medicine CurrentSince Aug 21, 2023 Accepting new patients
Superior Hospitalist Medical Group Inc Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Socal Hospitalists CurrentSince Aug 1, 2025 Accepting new patients

Locations

1111 E Spruce Ave
Ste 431
Fresno, CA 93720
Phone (559) 450-5611

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

1303 E Herndon Ave
Ste 850
Fresno, CA 93720
Phone (559) 450-5672

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

21163 Newport Coast Dr
Newport Coast, CA 92657
Phone (949) 233-0361

Interoperability endpoints

  • Direct secure messaging: nrezkalla2904154@direct.trinity-health.org

Organizations & group practices 4

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 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": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1386266724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SPRUCE AVE STE 431",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203330",
            "telephone_number": "559-450-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE STE 850",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203309",
            "telephone_number": "559-450-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Northgate Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523505",
            "country_code": "US",
            "telephone_number": "509-942-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZKALLA",
        "first_name": "NADER",
        "middle_name": "MAGDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-07",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A185455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.