Individual provider Active NPI

Richard E Fausel, DO

  • Adult Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1457300295
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
20A 5111 Issued in CA
Practice address
39000 Bob Hope Dr
Wright BLDG. Suite 410
Rancho Mirage, CA 92270-3221
Phone
(760) 773-1613
NPI assigned
May 9, 2006
Last updated
Mar 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 20A 5111 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Wright BLDG. Suite 410
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Wright BLDG. Suite 410
Rancho Mirage, CA 92270-3221
Phone (760) 773-1613

Other identifiers 1

IdentifierTypeStateIssuer
55062OtherCAFDA RADIOLOGY CERT #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A 5111CAMDAdult Medicine Physician
5111CAMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anh T. Duong, M.D., a Professional Corp Past Accepting new patients
Carlton W. Thomas, M.D., a Professional Corp Past Accepting new patients

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, 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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1457300295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "WRIGHT BLDG. SUITE 410",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "WRIGHT BLDG. SUITE 410",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-773-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSEL",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "20A 5111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA RADIOLOGY CERT #",
            "identifier": "55062",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.