Individual provider Active NPI

Keyvan Esmaeili, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Long Beach, CA
National Provider Identifier
1629008909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A72887 Issued in CA
Practice address
2840 Long Beach Blvd
130
Long Beach, CA 90806-1516
Phone
(562) 424-8111
Fax
(562) 492-6830
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A72887 CA Primary

Addresses

Primary practice location

2840 Long Beach Blvd
130
Long Beach, CA 90806-1516

Mailing address

2840 Long Beach Blvd
130
Long Beach, CA 90806-1516
Phone (562) 424-8111

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
I20040623000844 CA Practitioner - Physical Medicine and RehabilitationPractitioner - General Practice 7517942436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: General Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 764-4624

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • The Fudge Family Acute Rehabilitation Center Inpatient rehabilitation facility, Newport Beach, CA, CCN 05T224

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keyvan Esmaeili M D Inc Physical Medicine & Rehabilitation CurrentSince Apr 30, 2003 Accepting new patients

Locations

215 S Hickory St
Ste 118
Escondido, CA 92025
Phone (760) 432-6644

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Organizations & group practices 1

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 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629008909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 LONG BEACH BLVD",
            "address_2": "130",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061516",
            "telephone_number": "562-424-8111",
            "fax_number": "562-492-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 LONG BEACH BLVD",
            "address_2": "130",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061516",
            "telephone_number": "562-424-8111",
            "fax_number": "562-492-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESMAEILI",
        "first_name": "KEYVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A72887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.