Ghizal Naitaqi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A171217 Issued in CA

Practice address

1505 W 17TH St
San Bernardino, CA 92411-1202

Phone

(909) 887-6494

NPI assigned

Mar 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Lasalle Medical Associates

  • Multi-Specialty Clinic/Center
  • Redlands, CA
  • NPI 1891892535
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1528590700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W 17TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111202",
            "telephone_number": "909-887-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W 17TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111202",
            "telephone_number": "909-887-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAITAQI",
        "first_name": "GHIZAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A171217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myron L Massey DDS Inc (Dental Practice of San Bernardino)
• Nael Shahatto MD Inc
• Suneal P Naik, DDS
• Harilal Nair, NP
• Sumedh Nair
• Ahmed M. Naji, D.D.S
• Thoriya Youstina Nakoula
• Nakshatra RX Services Inc (San Rancho Pharmacy)
• Nancy K Bohl, Inc (The Counseling Team International)
• Nancy Samudio MD & Philis D Ransom MD, Inc, a Professional Medical Cor

• Pediatrics Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.