NPIMap

Individual provider Active NPI

Fariborz Mortazavi, M.D.

  • Hematology & Oncology Physician
  • Oxnard, CA
National Provider Identifier
1689782708
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A96026 Issued in CA
Practice address
1700 N Rose Ave Suite 320
Oxnard, CA 93030-7648
Phone
(805) 485-8709
Fax
(805) 485-5521
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036-107982 IL
Hematology & Oncology Physician 207RH0003X A96026 CA Primary

Addresses

Primary practice location

1700 N Rose Ave Suite 320
Oxnard, CA 93030-7648

Mailing address

1700 N Rose Ave
Suite 320
Oxnard, CA 93030-7648
Phone (805) 485-8709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620002205 CA Practitioner - Hematology/Oncology 8022015577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PMK Medical Group, Inc.Group PAC ID 9739127614, 7 clinicians

Practice addresses (Care Compare)

1700 N Rose Ave
Suite 320
Oxnard, CA 93030-7648
Phone (805) 485-8709

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.36 of 100Reported as individual
Quality
86.01
Improvement activities
40
Cost
80.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96026CAMDHematology & Oncology Physician
036-107982ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMK Medical Group, Inc. Hematology & Oncology CurrentSince Jul 1, 2016 Accepting new patients
Community Memorial Health System Past Accepting new patients
Ventura County Radiation Oncology Medical Group, Inc. PastSince Jul 1, 2016 Accepting new patients

Locations

500 Paseo Camarillo
Ste 106
Camarillo, CA 93010
Phone (805) 994-5485

1700 N Rose Ave
Ste 320
Oxnard, CA 93030
Phone (805) 485-8709

2900 Loma Vista Rd
Ste 200
Ventura, CA 93003
Phone (805) 485-8709

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 12

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1689782708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE",
            "address_2": "SUITE 320",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930307648",
            "telephone_number": "805-485-8709",
            "fax_number": "805-485-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE SUITE 320",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930307648",
            "telephone_number": "805-485-8709",
            "fax_number": "805-485-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTAZAVI",
        "first_name": "FARIBORZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036-107982",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A96026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.