Individual provider Active NPI

Adeeb Derakhshan

  • Otolaryngology Physician
  • Loma Linda, CA
National Provider Identifier
1730615287
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A188212 Issued in CA
Practice address
11234 Anderson St RM 2586a
Loma Linda, CA 92354-2804
Phone
(909) 558-7884
NPI assigned
May 3, 2017
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A188212 CA Primary
Otolaryngology Physician 207Y00000X D93707 MD

Addresses

Primary practice location

11234 Anderson St RM 2586a
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St RM 2586a
Loma Linda, CA 92354-2804
Phone (909) 558-7884

Other practice location 1

601 N Caroline St
Baltimore, MD 21287-0006
Phone (410) 955-5000

Other practice location 2

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-3007

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
I20231002002951 CA Practitioner - OtolaryngologyPractitioner - General Surgery 8820369911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: General Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

259 Terracina Blvd
Redlands, CA 92373-4847
Phone (909) 793-2634

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

28062 Baxter Rd
Murrieta, CA 92563-1401
Phone (909) 558-4000

28078 Baxter Rd
Murrieta, CA 92563-1402
Phone (909) 558-4000

3762 Tibbetts St
Riverside, CA 92506-2605
Phone (951) 686-2224

4646 Brockton Ave
Suite 103
Riverside, CA 92506-0103
Phone (909) 558-3111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D93707MDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
Socal Facial Plastic Surgery, Inc Current Accepting new patients
Beaver Medical Group P C CurrentSince Sep 11, 2025 Accepting new patients
Centers for Family Medicine GP Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2023 Accepting new patients
Beaver Medical Group P C CurrentSince Sep 11, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm PastSince Aug 6, 2023 Accepting new patients
Gastro Health Inc PastSince Aug 6, 2023 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
Rm 2586A
Loma Linda, CA 92350
Phone (909) 558-7884

11370 Anderson St
#2100
Loma Linda, CA 92354
Phone (909) 796-4822

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2600

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (760) 533-4541

28078 Baxter Rd
Ste 520
Murrieta, CA 92563

1895 Orange Tree Ln
Ste 102
Redlands, CA 92374
Phone (909) 558-2600

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

259 Terracina Blvd
Redlands, CA 92373
Phone (909) 328-5400

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

4646 Brockton Ave
Ste 103
Riverside, CA 92506
Phone (909) 558-2824

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

145 Thunder Dr
#1182
Vista, CA 92083
Phone (760) 941-9002

Interoperability endpoints

  • Direct secure messaging: aderakhshan867643@direct.llu.edu
  • Direct secure messaging: aderakshan23573@epiclp.direct-ci.com

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.

Hospital & facility affiliations 3

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1730615287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST RM 2586A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST RM 2586A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-7884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Caroline St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870006",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "243 Charles St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143002",
            "country_code": "US",
            "telephone_number": "617-573-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERAKHSHAN",
        "first_name": "ADEEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A188212",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D93707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.