Individual provider Active NPI

Alan Darush, M.D.

  • Internal Medicine Physician
  • Northridge, CA
National Provider Identifier
1649246794
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A84425 Issued in CA
Practice address
8540 Reseda Blvd
Suite 103
Northridge, CA 91324-4628
Phone
(818) 280-0700
Fax
(818) 993-6900
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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 A84425 CA Primary

Addresses

Primary practice location

8540 Reseda Blvd
Suite 103
Northridge, CA 91324-4628

Mailing address

PO Box 77790
Corona, CA 92877-0126
Phone (818) 280-0700

Other identifiers 1

IdentifierTypeStateIssuer
A84425OtherCASTATE LISENCE

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
I20041221000982 CA Practitioner - Internal Medicine 2466410535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1189 Swallow LN
Suite 100
Simi Valley, CA 93065-3157
Phone (805) 526-3365

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84425CAMDPharmacist
A84425CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Darush, M.D., a Professional Corporation Internal Medicine CurrentSince Jun 30, 2008 Accepting new patients
Beverly Hills Migraine and Pain Management Institute, Inc Past Accepting new patients

Locations

8540 Reseda Blvd
Ste 103
Northridge, CA 91324
Phone (424) 302-0289

1189 Swallow Ln
Ste 100
Simi Valley, CA 93065
Phone (805) 526-3365

Organizations & group practices 2

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1649246794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77790",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770126",
            "telephone_number": "818-280-0700",
            "fax_number": "818-993-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 RESEDA BLVD",
            "address_2": "SUITE 103",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244628",
            "telephone_number": "818-280-0700",
            "fax_number": "818-993-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARUSH",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A84425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISENCE",
            "identifier": "A84425",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.