Individual provider Active NPI

Omeed Azizirad, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Fremont, CA
National Provider Identifier
1386707651
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A99519 Issued in CA
Practice address
2000 Mowry Ave
Fremont, CA 94538-1716
Phone
(510) 797-1111
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006002051 MO
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A99519 CA Primary

Addresses

Primary practice location

2000 Mowry Ave
Fremont, CA 94538-1716

Mailing address

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

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
I20100121000229 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 4981746443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Township Medical FoundationGroup PAC ID 2860687050, 125 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 248-1000

39500 Fremont Blvd
Suite 100
Fremont, CA 94538-2101
Phone (510) 687-9510

Hospital & facility affiliations

  • Washington Hospital Hospital, Fremont, CA, CCN 050195
  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006002051MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Nov 1, 2010 Accepting new patients
Washington Township Medical Foundation Internal Medicine CurrentSince Nov 1, 2010 Accepting new patients

Locations

2557 Mowry Ave
Ste 10
Fremont, CA 94538
Phone (510) 248-1843

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

2500 Mowry Ave
Ste 255
Fremont, CA 94538

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1386707651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-797-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-797-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZIRAD",
        "first_name": "OMEED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2006002051",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A99519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.