Fariborz Lalezarzadeh, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A8309 Issued in CA

Practice address

164 W Hospitality LN Ste 100
San Bernardino, CA 92408-3316

Phone

(909) 883-8834

Fax

(909) 644-4021

NPI assigned

Aug 25, 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 3

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

General Surgery

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129
• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Fariborz Lalezarzadeh DO Inc

  • Surgery Physician
  • San Bernardino, CA
  • NPI 1285963124
  Medicare reassignment NPD Authorized official
• Surgical Edge Inc

  • Surgery Physician
  • San Bernardino, CA
  • NPI 1275488520
  NPD Authorized official
• Community Hospital of San Bernardino

  dba Community Convalescent Center of San Bernardino

  • Pediatric Skilled Nursing Facility
  • San Bernardino, CA
  • NPI 1851395685
  NPD (past)
• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)

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

• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  Care Compare affiliation
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1811004625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E REDLANDS BLVD STE U506",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736109",
            "telephone_number": "909-883-8834",
            "fax_number": "909-883-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083316",
            "telephone_number": "909-883-8834",
            "fax_number": "909-644-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALEZARZADEH",
        "first_name": "FARIBORZ",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A8309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "020A83090",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079700",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A83090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sebastian Lafo
• Rachael Renee Lagrand
• Julianna Laguna
• Karen Lai Liang, D.D.S
• Miranda Lakes
• Aidan Lam
• Oanh Lam
• Anne Elizabeth Lama
• Daniel J Lama, MD
• Daniel J Lama, MD

• Surgery Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.