Individual provider Active NPI

Abdulatif Gari, MD

  • Emergency Medicine Physician
  • Orange, CA
National Provider Identifier
1407352545
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
044-565 Issued in GA
Practice address
333 City Blvd W Ste 640
Orange, CA 92868-5915
Phone
(703) 485-7854
NPI assigned
Apr 5, 2018
Last updated
Apr 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 044-565 GA Primary

Addresses

Primary practice location

333 City Blvd W Ste 640
Orange, CA 92868-5915

Mailing address

333 City Blvd W Ste 640
Orange, CA 92868-5915
Phone (703) 485-7854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220105000597 KY Practitioner - Emergency Medicine 2264781152 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010412GAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1407352545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685915",
            "telephone_number": "703-485-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685915",
            "telephone_number": "703-485-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARI",
        "first_name": "ABDULATIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "044-565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.