Mohammad Nabulsi, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A137764 Issued in CA

Practice address

731 N Beach Blvd
Ste 175
La Habra, CA 90631-3657

Phone

(562) 697-6030

Fax

(562) 697-6263

NPI assigned

Apr 12, 2012

Last updated

Nov 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Family Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health Inland Empire Home health agency, Pomona, CA, CCN 557718
• Del Rosa Home Health, Inc. Home health agency, Corona, CA, CCN 559168
• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)
• St Jude Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Fullerton, CA
  • NPI 1649349705
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Del Rosa Home Health, Inc.

  • Home Health Agency
  • Corona, CA
  • NPI 1740719681
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation
• St. Joseph Health System Home Care Services

  dba North Star Home Health

  • Home Health Agency
  • Walnut, CA
  • NPI 1356706329
  Care Compare affiliation
• St. Joseph Health System Home Care Services LLC

  dba Providence Home Health Inland Empire

  • Home Health Agency
  • Pomona, CA
  • NPI 1649475948
  Care Compare affiliation

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1760749931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N BEACH BLVD",
            "address_2": "STE 175",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313657",
            "telephone_number": "562-697-6030",
            "fax_number": "562-697-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N BEACH BLVD",
            "address_2": "STE 175",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313657",
            "telephone_number": "562-697-6030",
            "fax_number": "562-697-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABULSI",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A137764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnabulsi1181634@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11900 South St # 13",
            "city": "Cerritos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907036847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnabulsi1181634@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "731 N Beach Blvd",
            "address_2": "Ste 175",
            "city": "La Habra",
            "state": "CA",
            "country_code": "US",
            "postal_code": "906313657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rosa L Munoz, CBD
• Staci Murguia, NUTRITIONIST
• Robert Miano Murimi
• Mve Home Health Care LLC
• Diane Myers, PA
• Calvin Tae Chun Nam, DDS
• Won Namgoong
• Anusha Nath, MD
• National Vision, Inc. (America's Best Contacts & Eyeglasses)
• Rosalie Guaring Navarro, PT

• Family Medicine Physician in La Habra, CA
• Providers in La Habra, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.