Individual provider Active NPI

Abraham Golbari, M.D.

  • Internal Medicine Physician
  • Gardena, CA
National Provider Identifier
1639216468
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A55387 Issued in CA
Practice address
14030 Crenshaw Blvd
Gardena, CA 90249-2715
Phone
(310) 327-8746
Fax
(310) 327-8748
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A55387 CA Primary

Addresses

Primary practice location

14030 Crenshaw Blvd
Gardena, CA 90249-2715

Mailing address

14030 Crenshaw Blvd
Gardena, CA 90249-2715
Phone (310) 327-8746

Other identifiers 1

IdentifierTypeStateIssuer
00A553870MedicaidCA

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
I20101207001104 CA Practitioner - Internal Medicine 8325235096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14030 Crenshaw Blvd
Gardena, CA 90249-2715

Hospital & facility affiliations

  • Memorial Hospital of Gardena Hospital, Gardena, CA, CCN 050468
  • Kindred Hospital South Bay Long-term care hospital, Gardena, CA, CCN 052050
  • Las Flores Convalescent Hospital Nursing home, Gardena, CA, CCN 555057

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Abraham Golbari, M.D. a Medical Corportation Internal Medicine CurrentSince Apr 30, 2003 Accepting new patients
Gardena Hospital LP Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

14030 Crenshaw Blvd
Gardena, CA 90249
Phone (310) 327-8746

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 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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639216468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14030 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492715",
            "telephone_number": "310-327-8746",
            "fax_number": "310-327-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14030 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492715",
            "telephone_number": "310-327-8746",
            "fax_number": "310-327-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLBARI",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A553870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.