Organization Active NPI

Rafael Lemus-Rangel MD a Medical Corporation

  • Surgery Physician
  • Lancaster, CA
National Provider Identifier
1487915120
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A107205 Issued in CA
Legal business name
RAFAEL LEMUS-RANGEL MD A MEDICAL CORPORATION
Practice address
1658 W Avenue J
Lancaster, CA 93534-2814
Phone
(661) 942-8855
Fax
(972) 616-5118
NPI assigned
May 29, 2012
Last updated
Aug 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Authorized official

Name
Dr. Rafael Lemus-RangelNPI 1609102433
Title
President
Phone
(661) 942-8855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A107205 CA Primary

Addresses

Primary practice location

1658 W Avenue J
Lancaster, CA 93534-2814

Mailing address

25050 Avenue Kearny
Suite 208
Valencia, CA 91355-1255
Phone (661) 430-0940

Other identifiers 1

IdentifierTypeStateIssuer
A107205OtherCAPRESIDENT MEDICAL STATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000427 CA Part B Supplier - Clinic/Group Practice 5294990255 Receives reassigned benefits from 4 practitioners
Practice locations: Palmdale, CA; Porterville, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1487915120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25050 AVENUE KEARNY",
            "address_2": "SUITE 208",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551255",
            "telephone_number": "661-430-0940",
            "fax_number": "661-295-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342814",
            "telephone_number": "661-942-8855",
            "fax_number": "972-616-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFAEL LEMUS-RANGEL MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "LEMUS-RANGEL",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-942-8855",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A107205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESIDENT MEDICAL STATE LICENSE NUMBER",
            "identifier": "A107205",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.