Organization Active NPI

North Lake Rehab and Medical Center Inc

  • Pain Medicine Physician
  • Pasadena, CA
National Provider Identifier
1386697977
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
A044253 Issued in CA
Legal business name
NORTH LAKE REHAB AND MEDICAL CENTER INC
Practice address
1403 N Fair Oaks Ave Ste 2
Pasadena, CA 91103-1893
Phone
(626) 798-8976
Fax
(626) 794-3010
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Authorized official

Name
Dr. Muhammad R Nasir, M.D.NPI 1427002526
Title
Owner/Doctor
Phone
(626) 798-8976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A044253 CA
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X A044253 CA Primary

Addresses

Primary practice location

1403 N Fair Oaks Ave Ste 2
Pasadena, CA 91103-1893

Mailing address

2052 N Lake Ave
Suite 2
Altadena, CA 91001-2450
Phone (626) 798-8976

Other identifiers 3

IdentifierTypeStateIssuer
00A442530MedicaidCA
00A442530OtherCACALIFORNIA BLUE SHIELD
P00119240OtherCARAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921001306 CA Part B Supplier - Clinic/Group Practice 5991773590 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1386697977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2052 N LAKE AVE",
            "address_2": "SUITE 2",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910012450",
            "telephone_number": "626-798-8976",
            "fax_number": "626-794-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 N FAIR OAKS AVE STE 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031893",
            "telephone_number": "626-798-8976",
            "fax_number": "626-794-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE REHAB AND MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "NASIR",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "626-798-8976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A044253",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A044253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A442530",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BLUE SHIELD",
            "identifier": "00A442530",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00119240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.