Individual provider Active NPI

Carolyn Abbasi

  • Anesthesiology Physician
  • Loma Linda, CA
National Provider Identifier
1811287311
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A125641 Issued in CA
Practice address
11234 Anderson St
Gme Office CSP 21005
Loma Linda, CA 92354-2804
Phone
(877) 558-4015
NPI assigned
Apr 18, 2011
Last updated
Dec 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A125641 CA Primary

Addresses

Primary practice location

11234 Anderson St
Gme Office CSP 21005
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Gme Office CSP 21005
Loma Linda, CA 92354-2804
Phone (877) 558-4015

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
I20160824001436 CA Practitioner - Anesthesiology 4284929662 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125641CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 8, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Anesthesiology CurrentSince Aug 8, 2016 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients

Locations

11234 Anderson St
Ofc Csp
Loma Linda, CA 92350
Phone (909) 558-4015

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: cabbasi4712@direct.llu.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1811287311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE CSP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "877-558-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE CSP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "877-558-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASI",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A125641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.