Individual provider Active NPI

Mark Farag, M.D.

  • Vascular Neurology Physician
  • Santa Fe Springs, CA
National Provider Identifier
1417375098
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
A141024 Issued in CA
Practice address
12400 Bloomfield Ave FL 3
Santa Fe Springs, CA 90670-4750
Phone
(562) 967-2801
Fax
(562) 967-2804
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X A141024 CA Primary

Addresses

Primary practice location

12400 Bloomfield Ave FL 3
Santa Fe Springs, CA 90670-4750

Mailing address

12400 Bloomfield Ave FL 3
Santa Fe Springs, CA 90670-4750
Phone (562) 967-2801

Other practice location 1

101 The City Drive , City Tower
Suite 400
Orange, CA 92868
Phone (714) 273-0388

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
I20190912002197 CA Practitioner - Neurosurgery 4587952403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

12400 Bloomfield Ave
Santa Fe Springs, CA 90670-4750
Phone (562) 967-2820

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141024CAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Family Medicine Current Accepting new patients
Pih Health Physicians CurrentSince Jun 23, 2019 Accepting new patients
Pih Health Physicians Family Medicine CurrentSince Jun 23, 2019 Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Pih Health Physicians Family Medicine PastSince Nov 29, 2020 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Locations

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

12400 Bloomfield Ave
Santa Fe Springs, CA 90670
Phone (562) 789-5434

12400 Bloomfield Ave
Fl 3
Santa Fe Springs, CA 90670
Phone (562) 967-2760

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: markfarag@pihh.allscriptsdirect.net

Organizations & group practices 6

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1417375098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 BLOOMFIELD AVE FL 3",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906704750",
            "telephone_number": "562-967-2801",
            "fax_number": "562-967-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 BLOOMFIELD AVE FL 3",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906704750",
            "telephone_number": "562-967-2801",
            "fax_number": "562-967-2804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Drive , City Tower",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "92868",
            "country_code": "US",
            "telephone_number": "714-273-0388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAG",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A141024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.