Individual provider Active NPI

Jamila Moucharrafie, MD

  • Pediatrics Physician
  • Anaheim, CA
National Provider Identifier
1578919783
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A150961 Issued in CA
Practice address
1781 W Romneya Dr Ste E
Anaheim, CA 92801-1818
Phone
(714) 774-0414
NPI assigned
May 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A150961 CA Primary

Addresses

Primary practice location

1781 W Romneya Dr Ste E
Anaheim, CA 92801-1818

Mailing address

1781 W Romneya Dr Ste E
Anaheim, CA 92801-1818

Other practice location 1

11234 Anderson St
Loma Linda University Health-Pediatrics
Loma Linda, CA 92354-2804
Phone (909) 558-4174

Other practice location 2

21634 Retreat Pkwy
Temescal Valley, CA 92883-6100
Phone (951) 683-6370

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
I20191015001096 CA Practitioner - Pediatric Medicine 7012248503 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A150961CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J. Moucharrafie, MD, Inc. Pediatrics CurrentSince Jan 21, 2024 Accepting new patients
Riverside Medical Clinic, Inc Pediatrics CurrentSince Sep 1, 2019 Accepting new patients
Riverside Medical Clinic, Inc Pediatrics CurrentSince Sep 1, 2019 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients

Locations

1781 W Romneya Dr
Ste E
Anaheim, CA 92801
Phone (714) 774-0414

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1578919783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 W ROMNEYA DR STE E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 W ROMNEYA DR STE E",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011818",
            "telephone_number": "714-774-0414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "Loma Linda University Health-Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21634 Retreat Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temescal Valley",
            "state": "CA",
            "postal_code": "928836100",
            "country_code": "US",
            "telephone_number": "951-683-6370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUCHARRAFIE",
        "first_name": "JAMILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A150961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.