Individual provider Active NPI

Raffi Hodikian, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1760633630
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A107319 Issued in CA
Practice address
2040 S Santa Cruz St Ste 240
Anaheim, CA 92805-6805
Phone
(714) 202-2330
NPI assigned
Oct 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60247609 NY
Internal Medicine Physician 207R00000X A107319 CA Primary

Addresses

Primary practice location

2040 S Santa Cruz St Ste 240
Anaheim, CA 92805-6805

Mailing address

4900 California Ave,Tower B 2ND FL
Bakersfield, CA 93309
Phone (866) 949-0108

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
I20100107000687 CA Practitioner - Internal MedicinePractitioner - Family Practice 2466593892 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Hospitalist Network Medical Group IncGroup PAC ID 8921990110, 76 clinicians

Practice addresses (Care Compare)

625 The City Dr S
Suite 320
Orange, CA 92868-4978
Phone (714) 202-2330

Hospital & facility affiliations

  • Tea Healthcare Services Inc Home health agency, Covina, CA, CCN 058252
  • Bristol Hospice- Northern Los Angeles Hospice, Glendale, CA, CCN 551546
  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Monrovia Post Acute Nursing home, Duarte, CA, CCN 055259
  • Glendora Canyon Transitional Care Unit Nursing home, Glendora, CA, CCN 555416

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107319CAMDInternal Medicine Physician
60247609NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Hospitalist Network Medical Group Inc Internal Medicine CurrentSince Oct 21, 2009 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 14, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Apr 14, 2013 Accepting new patients

Locations

2040 S Santa Cruz St
Ste 240
Anaheim, CA 92805
Phone (714) 202-2330

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: raffihodikian@hcpca.allscriptsdirect.net
  • Direct secure messaging: ms_rhodikia@landmarkhealth-direct.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bristol Hospice - Northern Los AngelesGlendale, CA, CCN 551546 Hospice Contracted Managing Employee Jun 16, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 10

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1760633630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE,TOWER B 2ND FL",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93309",
            "telephone_number": "866-949-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 S SANTA CRUZ ST STE 240",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056805",
            "telephone_number": "714-202-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODIKIAN",
        "first_name": "RAFFI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "60247609",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A107319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.