Individual provider Active NPI

Wahida Azimi, D.O.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1821292079
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A14031 Issued in CA
Practice address
9480 S Eastern Ave Suite 262
Henderson, NV 89052-2982
Phone
(702) 407-7700
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C7-0003796 DE
Hospitalist Physician 208M00000X DO2070 NV
Internal Medicine Physician 207R00000X 20A14031 CA Primary
Internal Medicine Physician 207R00000X DO2070 NV

Addresses

Primary practice location

9480 S Eastern Ave Suite 262
Henderson, NV 89052-2982

Mailing address

10624 S Eastern Ave
# A-955
Henderson, NV 89052-2982
Phone (702) 877-8600

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
I20180620002905 CA Practitioner - Internal Medicine 6002005782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus on Health Inc 63 clinicians

Practice addresses (Care Compare)

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14031CAMDInternal Medicine Physician
C7-0003796DEMDInternal Medicine Physician
DO2070NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on Health Inc CurrentSince Mar 1, 2024 Accepting new patients
San Diego Hospitalist Associates Inc Hospitalist CurrentSince Jul 1, 2018 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Jul 1, 2018 Accepting new patients
Dignity Health Past Accepting new patients

Locations

8695 Spectrum Center Ct
San Diego, CA 92123
Phone (858) 499-3025

8765 Aero Dr
Ste 130
San Diego, CA 92123
Phone (858) 541-0181

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

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 2

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1821292079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10624 S EASTERN AVE",
            "address_2": "# A-955",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-877-8600",
            "fax_number": "702-242-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 S EASTERN AVE SUITE 262",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522982",
            "telephone_number": "702-407-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIMI",
        "first_name": "WAHIDA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C7-0003796",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "DO2070",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14031",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO2070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.