Individual provider Active NPI

Farnoosh Nadalizadeh, PA-C

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1619665189
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63903 Issued in CA
Practice address
113 Waterworks Way Ste 240
Irvine, CA 92618-3175
Phone
(949) 340-9622
Fax
(949) 528-3969
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA63903 CA Primary

Addresses

Primary practice location

113 Waterworks Way Ste 240
Irvine, CA 92618-3175

Mailing address

400 Limestone Apt 311
Irvine, CA 92603-4109
Phone (949) 413-9768

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529002675 CA Practitioner - Physician Assistant 0840632303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Align Spine CenterGroup PAC ID 3375884679, 7 clinicians

Practice addresses (Care Compare)

113 Waterworks Way
Suite 240
Irvine, CA 92618-3175
Phone (949) 340-9622

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63903CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Pain Institute of Orange County, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1619665189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LIMESTONE APT 311",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926034109",
            "telephone_number": "949-413-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183175",
            "telephone_number": "949-340-9622",
            "fax_number": "949-528-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADALIZADEH",
        "first_name": "FARNOOSH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.