Individual provider Active NPI

Mohammad B Rahimi, MD

  • Pediatric Cardiology Physician
  • Long Beach, CA
National Provider Identifier
1609971290
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A77508 Issued in CA
Practice address
2701 Atlantic Ave
Long Beach, CA 90806-2701
Phone
(714) 377-6993
Fax
(562) 427-1987
NPI assigned
Sep 14, 2006
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 2005021812 MO
Pediatric Cardiology Physician 2080P0202X A77508 CA Primary

Addresses

Primary practice location

2701 Atlantic Ave
Long Beach, CA 90806-2701

Mailing address

2701 Atlantic Ave
Long Beach, CA 90806-2701
Phone (714) 377-6993

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://fhir.memorialcare.org/fhir/api/FHIR/R4 Health Information Exchange (HIE) MemorialCare Medical Foundation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041029000744 CA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 0345202503 Reassigns benefits to 1 organization
I20051109001239 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 0345202503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

2880 Atlantic Ave
Suite 255
Long Beach, CA 90806-1734
Phone (562) 728-5210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77508CAMDPharmacist
A77508CAMDPediatric Cardiology Physician
2005021812MOMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Oct 1, 2020 Accepting new patients
SSM Health Care St Louis CurrentSince Jan 1, 2016 Accepting new patients
Northeast Valley Health Corporation Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Cardinal Glennon Childrens Hospital Past Accepting new patients
SSM Cardinal Glennon Children's Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Southeast Hospital Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Northeast Valley Health Corporation Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Anderson Hospital Past Accepting new patients
Mercy Hospital South Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

4050 Barranca Pkwy
Ste 200
Irvine, CA 92604
Phone (949) 551-1090

2701 Atlantic Ave
Long Beach, CA 90806
Phone (562) 684-8096

2880 Atlantic Ave
Ste 255
Long Beach, CA 90806
Phone (562) 424-4815

30492 Gateway Pl
Ste 110
Rancho Mission Viejo, CA 92694
Phone (657) 241-8601

3640 Lomita Blvd
Ste 102
Torrance, CA 90505
Phone (310) 378-8232

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mrahimi647947@direct.memorialcare.org

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1609971290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062701",
            "telephone_number": "714-377-6993",
            "fax_number": "562-427-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062701",
            "telephone_number": "714-377-6993",
            "fax_number": "562-427-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIMI",
        "first_name": "MOHAMMAD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MO",
            "license": "2005021812",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A77508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.memorialcare.org/fhir/api/FHIR/R4",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.