Active NPI
Azadeh Rose Fayazi, MD
- Pediatric Critical Care Medicine Physician
- Palo Alto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- A115936
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8000
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | A115936 | CA | Primary |
| Pediatrics Physician | 208000000X | A115936 | CA |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other practice location 1
630 Park View Dr Apt 212
Santa Clara, CA 95054-3580
Phone (614) 286-5096
Other practice location 2
630 Park View Dr Apt 212
Santa Clara, CA 95054-3580
Phone (614) 286-5096
Other practice location 3
770 Welch Rd
Palo Alto, CA 94304
Phone (650) 736-9828
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A115936 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LPCH Medical Group Div of Lucile | Pediatrics | Current | Accepting new patients |
Locations
9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700
770 Welch Rd
Palo Alto, CA 94304
Phone (650) 498-4069
725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1639388994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8000"
}
],
"practiceLocations": [
{
"address_1": "630 Park View Dr Apt 212",
"address_purpose": "LOCATION",
"city": "Santa Clara",
"state": "CA",
"postal_code": "950543580",
"country_code": "US",
"telephone_number": "614-286-5096",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "630 Park View Dr Apt 212",
"address_purpose": "LOCATION",
"city": "Santa Clara",
"state": "CA",
"postal_code": "950543580",
"country_code": "US",
"telephone_number": "614-286-5096",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "770 Welch Rd",
"address_purpose": "LOCATION",
"city": "Palo Alto",
"state": "CA",
"postal_code": "94304",
"country_code": "US",
"telephone_number": "650-736-9828",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAYAZI",
"first_name": "AZADEH",
"middle_name": "ROSE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "CA",
"license": "A115936",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A115936",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.