NPIMap

Individual provider Active NPI

Maryam Rahimi, D.O.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Huntington Beach, CA
National Provider Identifier
1700066149
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
20A10143 Issued in CA
Practice address
19066 Magnolia St
Huntington Beach, CA 92646-2232
Phone
(949) 610-1042
Fax
(949) 610-1049
NPI assigned
Nov 13, 2007
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 005474 AZ
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 20A10143 CA Primary

Addresses

Primary practice location

19066 Magnolia St
Huntington Beach, CA 92646-2232

Mailing address

5318 E 2ND St # 670
Long Beach, CA 90803-5324
Phone (949) 610-1042

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
I20110914000579 CA Practitioner - Physical Medicine and Rehabilitation 2769506690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19066 Magnolia St
Huntington Beach, CA 92646-2232
Phone (949) 610-1042

5318 E 2ND St
Suite 670
Long Beach, CA 90803-5324

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10143CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rahimi Inc Sports Medicine CurrentSince Apr 16, 2015 Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients
Sun Health Corporation Past Accepting new patients
Multi Specialty Physicians Inc Past Accepting new patients
Banner del E Webb Medical Center Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients
Westside Pain Management, Inc. Past Accepting new patients

Locations

19066 Magnolia St
Huntington Beach, CA 92646
Phone (714) 378-2225

8201 Newman Ave
Ste 302
Huntington Beach, CA 92647
Phone (714) 848-0310

5318 E 2nd St
Long Beach, CA 90803

3300 W Coast Hwy
Ste C
Newport Beach, CA 92663
Phone (541) 554-5959

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1700066149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 E 2ND ST # 670",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035324",
            "telephone_number": "949-610-1042",
            "fax_number": "949-610-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19066 MAGNOLIA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926462232",
            "telephone_number": "949-610-1042",
            "fax_number": "949-610-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIMI",
        "first_name": "MARYAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "005474",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "20A10143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.