NPIMap

Individual provider Active NPI

Bachar Kurdi, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fountain Valley, CA
National Provider Identifier
1750483327
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A69719 Issued in CA
Practice address
11100 Warner Ave
Suite 254
Fountain Valley, CA 92708-7506
Phone
(714) 546-5967
Fax
(714) 546-5970
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A69719 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Suite 254
Fountain Valley, CA 92708-7506

Mailing address

14252 Culver Dr
Pmb903
Irvine, CA 92604-0317
Phone (714) 546-5967

Other identifiers 1

IdentifierTypeStateIssuer
A69719OtherCAMEDICAL LICENSE

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
I20050613001016 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 9537103320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11100 Warner Ave
Suite 254
Fountain Valley, CA 92708-7502
Phone (714) 546-5967

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.75 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
85.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69719CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bachar Kurdi MD Medical Corporation Endocrinology, Diabetes & Metabolism CurrentSince Mar 1, 2012 Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
THC - Orange County LLC Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients
Southern California Specialty Care, LLC Past Accepting new patients

Locations

11100 Warner Ave
Ste 254
Fountain Vly, CA 92708
Phone (714) 246-6388

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 6

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1750483327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14252 CULVER DR",
            "address_2": "PMB903",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040317",
            "telephone_number": "714-546-5967",
            "fax_number": "714-546-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 254",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-546-5967",
            "fax_number": "714-546-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURDI",
        "first_name": "BACHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A69719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A69719",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.