Individual provider Active NPI

M Mash-Hoordin Rajudin, MD

  • Nephrology Physician
  • Anaheim, CA
National Provider Identifier
1790892230
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A26154 Issued in CA
Practice address
3055 W Orange Ave Ste 204
Anaheim, CA 92804-3154
Phone
(714) 229-9500
Fax
(714) 229-9904
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A26154 CA Primary

Addresses

Primary practice location

3055 W Orange Ave Ste 204
Anaheim, CA 92804-3154

Mailing address

3055 W Orange Ave Ste 204
Anaheim, CA 92804-3154
Phone (714) 229-9500

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
I20100519000336 CA Practitioner - NephrologyPractitioner - Internal Medicine 7416086186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3055 W Orange Ave
Suite 204
Anaheim, CA 92804-3154

Hospital & facility affiliations

  • Venerable Hospice Care Hospice, Glendale, CA, CCN B51754
  • Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226
  • West Anaheim Medical Center Hospital, Anaheim, CA, CCN 050426

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M. Rajudin, M.D., Inc. Nephrology CurrentSince Sep 1, 2013 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients

Locations

3033 W Orange Ave
Anaheim, CA 92804
Phone (714) 229-5649

3055 W Orange Ave
Ste 204
Anaheim, CA 92804
Phone (714) 229-9500

3010 W Orange Ave
Ste 404
Anaheim, CA 92804
Phone (714) 229-9500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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
Venerable Hospice CareGlendale, CA, CCN B51754 Hospice Contracted Managing Employee (100%) Oct 29, 2024

Owned or controlled facilities with NPI records 1

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 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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1790892230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 W ORANGE AVE STE 204",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043154",
            "telephone_number": "714-229-9500",
            "fax_number": "714-229-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 W ORANGE AVE STE 204",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043154",
            "telephone_number": "714-229-9500",
            "fax_number": "714-229-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJUDIN",
        "first_name": "M",
        "middle_name": "MASH-HOORDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A26154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.