Individual provider Active NPI

Sandra Qaseem, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Murrieta, CA
National Provider Identifier
1629083191
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
2004-0648 Issued in NM
Practice address
39765 Date St Ste 102
Murrieta, CA 92563-2005
Phone
(951) 894-4665
Fax
(951) 894-5178
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2004-0648 NM Primary

Addresses

Primary practice location

39765 Date St Ste 102
Murrieta, CA 92563-2005

Mailing address

39765 Date St Ste 102
Murrieta, CA 92563-2005
Phone (951) 894-4665

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
I20220607002761 CA Practitioner - Family Practice 8325099393 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-0648NMMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Aug 1, 2022 Accepting new patients
Healthcare Crossing Corporation CurrentSince Jun 3, 2022 Accepting new patients
Sac Health System CurrentSince Aug 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 16, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 16, 2022 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

39765 Date St
Ste 100
Murrieta, CA 92563
Phone (951) 279-0100

39765 Date St
Ste 102
Murrieta, CA 92563

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: sandra.qaseem.1@10674.direct.athenahealth.com
  • Direct secure messaging: sqaseem550731@direct.llu.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1629083191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39765 DATE ST STE 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632005",
            "telephone_number": "951-894-4665",
            "fax_number": "951-894-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39765 DATE ST STE 102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632005",
            "telephone_number": "951-894-4665",
            "fax_number": "951-894-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QASEEM",
        "first_name": "SANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-06-24",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "2004-0648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.