Individual provider Active NPI

Rachael H Robison

  • Family Medicine Physician
  • Northridge, CA
National Provider Identifier
1497011340
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A13148 Issued in CA
Practice address
18406 Roscoe Blvd
Northridge Family Medicine Residency
Northridge, CA 91325-4107
Phone
(818) 885-8500
Fax
(818) 727-0793
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 20A13148 CA Primary

Addresses

Primary practice location

18406 Roscoe Blvd
Northridge Family Medicine Residency
Northridge, CA 91325-4107

Mailing address

18406 Roscoe Blvd
Northridge Family Medicine Residency
Northridge, CA 91325-4107
Phone (818) 885-8500

Other names 1

  • Rachael Han Former name

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
I20150120001718 CA Practitioner - Family Practice 0244554327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

411 N Lakeview Ave
Anaheim, CA 92807-3028
Phone (714) 279-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13148CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2015 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

411 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1497011340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18406 ROSCOE BLVD",
            "address_2": "NORTHRIDGE FAMILY MEDICINE RESIDENCY",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-885-8500",
            "fax_number": "818-727-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18406 ROSCOE BLVD",
            "address_2": "NORTHRIDGE FAMILY MEDICINE RESIDENCY",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-885-8500",
            "fax_number": "818-727-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "RACHAEL",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "HAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.