Active NPI
Tariq Jamil
- Specialist
- San Bernardino, CA
National Provider Identifier
1629159876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A70628
- Practice address
- 399 E Highland Ave
Suite 502
San Bernardino, CA 92404-3808 - Phone
- (909) 883-3838
- NPI assigned
- Oct 17, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A70628 | CA | Primary |
Addresses
Primary practice location
399 E Highland Ave
Suite 502
San Bernardino, CA 92404-3808
Mailing address
910 Creekside Dr
Redlands, CA 92373-6983
Phone (909) 883-3838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A706280 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031111000917 | CA | Practitioner - Pulmonary Disease | 4587577820 | Practice locations: San Bernardino, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
355 E 21St St
Suite G
San Bernardino, CA 92404-4851
Phone (909) 883-3838
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 16.68 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 55.62
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A70628 | CA | MD | Specialist |
| 70628 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shuang Bai, M.D. Inc. | Past | Accepting new patients | |
| Primary Care Medical Group of Inland Empire, Inc | Past | Accepting new patients | |
| Adnan Misellati, M.D., Inc | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Riverside, CA
- NPI 1659735967
-
dba Inland Sleep Center, A Medical Group
- Multi-Specialty Clinic/Center
- San Bernardino, CA
- NPI 1255412474
-
- Internal Medicine Physician
- San Bernardino, CA
- NPI 1003397936
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Bernardino, CA
- NPI 1235290818
-
dba St. Bernardine Medical Center
- General Acute Care Hospital
- San Bernardino, CA
- NPI 1689769911
-
dba Ballard Rehabilitation Hospital
- Rehabilitation Hospital
- San Bernardino, CA
- NPI 1497748081
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1629159876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 CREEKSIDE DR",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923736983",
"telephone_number": "909-883-3838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 E HIGHLAND AVE",
"address_2": "SUITE 502",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043808",
"telephone_number": "909-883-3838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMIL",
"first_name": "TARIQ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A70628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A706280",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.