Individual provider Active NPI

Mustafa Rawy, MD

  • Pediatrics Physician
  • Porterville, CA
National Provider Identifier
1730602038
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A165085 Issued in CA
Practice address
65 N Hockett Street
Porterville, CA 93257
Phone
(559) 544-6570
NPI assigned
Jul 19, 2017
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X A165085 CA Primary

Addresses

Primary practice location

65 N Hockett Street
Porterville, CA 93257

Mailing address

65 N Hockett Street
Porterville, CA 93257
Phone (559) 544-6570

Other practice location 1

300 Second Ave
Long Branch, NJ 07740
Phone (732) 923-7251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201013001335 CA Practitioner - Pediatric Medicine 5698195683 Reassigns benefits to 1 organization
I20250129000124 NV Practitioner - Pediatric Medicine 5698195683 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A165085CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Aug 19, 2020 Accepting new patients
Family Healthcare Network CurrentSince Aug 19, 2020 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Pokroy Medical Group of Nevada, LTD. Pediatrics CurrentSince Feb 1, 2025 Accepting new patients
Dignity Health Past Accepting new patients

Locations

File 50978
Los Angeles, CA 90074

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

65 N Hockett St
Porterville, CA 93257
Phone (559) 544-6570

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

3001 Saint Rose Pkwy
Henderson, NV 89052
Phone (702) 615-5000

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

1240 E 9th St
Reno, NV 89512
Phone (775) 323-0478

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 10

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1730602038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N HOCKETT STREET",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "93257",
            "telephone_number": "559-544-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N HOCKETT STREET",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "93257",
            "telephone_number": "559-544-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Second Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "07740",
            "country_code": "US",
            "telephone_number": "732-923-7251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAWY",
        "first_name": "MUSTAFA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A165085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.