Bassam A Hadaya, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A29939 Issued in CA

Practice address

1759 W Avenue J
Ste 101
Lancaster, CA 93534-2703

Phone

(661) 948-1388

Fax

(661) 948-1223

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles

  dba Antelope Valley Health Center

  • State or Local Public Health Clinic/Center
  • Lancaster, CA
  • NPI 1437344884
  NPD
• Indian Wells Valley Dialysis Medical Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ridgecrest, CA
  • NPI 1154427243
  NPD (past)
• Palmdale Regional Dialysis Medical Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Palmdale, CA
  • NPI 1386740470
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1801864301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2768",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392768",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 W AVENUE J",
            "address_2": "STE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342703",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADAYA",
        "first_name": "BASSAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A29939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP CORP TAX ID",
            "identifier": "95-4056336",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA299390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liliana Guzman
• Lizzett Guzman, BCBA
• Mark Habib, OD
• Melad Habib
• Reza Hadavi, LMFT
• Bassel Hadaya, M.D.
• Mona T Hadaya, D. D. S.
• Rami M Haddad, D.D.S
• Shihab Samuel Haddad, DC
• Dennis Patrick Hagerty, M.A.

• Nephrology Physician in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.