NPIMap

Individual provider Active NPI

Rajiv I Bhavsar, M.D.

  • Internal Medicine Physician
  • Fullerton, CA
National Provider Identifier
1477550648
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C 50717 Issued in CA
Practice address
1321 N Harbor Blvd
Suite # 302
Fullerton, CA 92835-4124
Phone
(714) 441-0591
Fax
(714) 441-0594
NPI assigned
Jul 4, 2005
Last updated
Sep 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C 50717 CA Primary

Addresses

Primary practice location

1321 N Harbor Blvd
Suite # 302
Fullerton, CA 92835-4124

Mailing address

1321 N Harbor Blvd
Suite # 302
Fullerton, CA 92835-4124
Phone (714) 441-0591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000573 CA Practitioner - Internal Medicine 7618905456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1321 N Harbor Blvd
Suite 302
Fullerton, CA 92835-4131
Phone (714) 441-0591

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C 50717CAMDInternal Medicine Physician
50717CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Pulmonary Medical Group Inc Internal Medicine CurrentSince Feb 7, 2012 Accepting new patients
Rajiv Ishwarlal Bhavsar, M.D., a Medical Corporation Internal Medicine CurrentSince Sep 20, 2011 Accepting new patients
Universal Care PastSince Sep 20, 2011 Accepting new patients
Jessamine County Health Department PastSince Apr 8, 2012 Accepting new patients

Locations

1321 N Harbor Blvd
Ste 302
Fullerton, CA 92835
Phone (714) 441-0591

1440 N Harbor Blvd
Ste 114
Fullerton, CA 92835
Phone (714) 446-7454

220 Laguna Rd
Ste 2
Fullerton, CA 92835
Phone (714) 255-8343

301 W Bastanchury Rd
Ste 220
Fullerton, CA 92835
Phone (714) 446-7454

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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": "1120435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1477550648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD",
            "address_2": "SUITE # 302",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354124",
            "telephone_number": "714-441-0591",
            "fax_number": "714-441-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD",
            "address_2": "SUITE # 302",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354124",
            "telephone_number": "714-441-0591",
            "fax_number": "714-441-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAVSAR",
        "first_name": "RAJIV",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-04",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C 50717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.