Fady Rezk

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

13422 Newport Ave Ste L
Tustin, CA 92780-3746

Phone

(714) 544-1521

NPI assigned

Oct 8, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rita R Ellithorpe MD IncGroup PAC ID 8729353065, 6 clinicians

Sun Medical Group IncGroup PAC ID 8426388810, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Rita R Ellithorpe MD, Inc

  • Prevention Professional
  • Santa Ana, CA
  • NPI 1619403854
  Medicare reassignment Care Compare group
• Sun Medical Group, Inc

  • Urgent Care Clinic/Center
  • Ladera Ranch, CA
  • NPI 1114588704
  Medicare reassignment Care Compare group
• Prohealth Partners a Medical Group Inc

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1447382411
  NPD
• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1497574230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907140740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE STE L",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-544-1521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917661854",
            "country_code": "US",
            "telephone_number": "909-469-5378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZK",
        "first_name": "FADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler J Reyes
• Sully Reyes
• Madelyn Kent Reynolds
• Livan Reynoso
• Sahar Rezaei, PHARM.D.
• Lisa Lynn Rezner
• Seyoon Rhee, DC
• Sumin Rhee, DDS
• Randall Craig Rheinheimer, PH.D., MFT
• Reata Lyn Rhine, LCSW

• Physician Assistant in Tustin, CA
• Providers in Tustin, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.