Individual provider Active NPI

Joseph Yadegar, MD

  • Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1467407064
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A33119 Issued in CA
Practice address
9301 Wilshire Blvd
Ste 414
Beverly Hills, CA 90210-6144
Phone
(310) 858-8646
Fax
(310) 858-2622
NPI assigned
May 23, 2006
Last updated
Mar 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A33119 CA Primary

Addresses

Primary practice location

9301 Wilshire Blvd
Ste 414
Beverly Hills, CA 90210-6144

Mailing address

9301 Wilshire Blvd
#414
Beverly Hills, CA 90210-5424
Phone (310) 858-8646

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
I20080115000740 CA Practitioner - General SurgeryPractitioner - General Practice 8527149574 Practice locations: Beverly Hills, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33119CAMDPsychologist
A33119CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rexford Operating Rooms Inc. CurrentSince Mar 8, 2002 Accepting new patients

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1467407064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 WILSHIRE BLVD",
            "address_2": "#414",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105424",
            "telephone_number": "310-858-8646",
            "fax_number": "310-858-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 WILSHIRE BLVD",
            "address_2": "STE 414",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902106144",
            "telephone_number": "310-858-8646",
            "fax_number": "310-858-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADEGAR",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A33119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.