NPIMap

Individual provider Active NPI

Amr Al-Hariri, M.D.

  • Neurology Physician
  • Templeton, CA
National Provider Identifier
1497862254
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A54396 Issued in CA
Practice address
1050 Las Tablas Rd
Suite 10
Templeton, CA 93465-9729
Phone
(805) 434-2482
Fax
(805) 456-7702
NPI assigned
Aug 25, 2006
Last updated
Aug 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A54396 CA
Neurology Physician 2084N0400X A54396 CA Primary

Addresses

Primary practice location

1050 Las Tablas Rd
Suite 10
Templeton, CA 93465-9729

Mailing address

9850 Genesee Ave Ste 900
La Jolla, CA 92037-1220
Phone (858) 626-4604

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ59625YOtherCABLUE SHIELD PIN

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
I20070523000419 CA Practitioner - NeurologyPractitioner - Pediatric Medicine 0244337459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pavilion Neurology Medical Group Inc.Group PAC ID 8921034992, 5 clinicians

Practice addresses (Care Compare)

1140 W la Veta Ave
Suite 730
Orange, CA 92868-4229
Phone 7145416800221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54396CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pavilion Neurology Medical Group Inc. CurrentSince Jul 13, 2015 Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Scripps Health Past Accepting new patients
Access Telecare California, P.C. Internal Medicine Past Accepting new patients

Locations

1140 W La Veta Ave
Ste 730
Orange, CA 92868
Phone (714) 541-6800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amral-hariri@pavnmg.allscriptsdirect.net

Organizations & group practices 7

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 3

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1497862254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 900",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371220",
            "telephone_number": "858-626-4604",
            "fax_number": "858-626-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LAS TABLAS RD",
            "address_2": "SUITE 10",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659729",
            "telephone_number": "805-434-2482",
            "fax_number": "805-456-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HARIRI",
        "first_name": "AMR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54396",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A54396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ59625Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

Verify at the official NPI Registry.