Individual provider Active NPI

Amol Rajeev Rao, M.D.

  • Hematology & Oncology Physician
  • Fountain Valley, CA
National Provider Identifier
1689871154
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A112418 Issued in CA
Practice address
18111 Brookhurst St Ste 6100
Fountain Valley, CA 92708-6728
Phone
(714) 378-7330
Fax
(714) 377-0003
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A112418 CA Primary

Addresses

Primary practice location

18111 Brookhurst St Ste 6100
Fountain Valley, CA 92708-6728

Mailing address

18111 Brookhurst St Ste 6100
Fountain Valley, CA 92708-6728
Phone (714) 378-7330

Other practice location 1

24411 Health Center Dr Ste 320
Laguna Hills, CA 92653-3633
Phone (949) 380-2670

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation
Direct Messaging Address arao239698@direct.memorialcare.org Direct MemorialCare Medical Foundation

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
I20110307000815 CA Practitioner - Hematology/Oncology 0941482384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

100 S Anaheim Blvd
Suite 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone (714) 549-1300

1212 W 17TH St
Santa Ana, CA 92706-3418
Phone (714) 954-0432

15464 Goldenwest St
Westminster, CA 92683-6149
Phone (714) 891-9008

17360 Brookhurst St
Fountain Valley, CA 92708-3720

17762 Beach Blvd
Huntington Beach, CA 92647-6860
Phone (714) 848-0080

18111 Brookhurst St
Suite 6100
Fountain Valley, CA 92708-6728
Phone (714) 378-7330

24268 El Toro Rd
Laguna Woods, CA 92637-3435
Phone (657) 241-8455

24411 Health Ctr Dr
Laguna Hills, CA 92653-3633

24411 Health Ctr Dr
Suite 620
Laguna Hills, CA 92653-3672
Phone (657) 241-8270

722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112418CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation CurrentSince Feb 1, 2021 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

18111 Brookhurst St
Ste 6100
Fountain Vly, CA 92708
Phone (714) 378-7330

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24411 Health Center Dr
Ste 320
Laguna Hills, CA 92653
Phone (949) 380-2670

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 2

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1689871154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 6100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-378-7330",
            "fax_number": "714-377-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 6100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-378-7330",
            "fax_number": "714-377-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24411 Health Center Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926533633",
            "country_code": "US",
            "telephone_number": "949-380-2670",
            "fax_number": "949-380-0907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "AMOL",
        "middle_name": "RAJEEV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A112418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare  FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arao239698@direct.memorialcare.org",
            "affiliation": "Y",
            "endpointDescription": "Secure Email",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.