Individual provider Active NPI

Anahita Rezaie, MD

  • Gastroenterology Physician
  • Duarte, CA
National Provider Identifier
1821294000
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C55510 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010
Phone
(626) 256-4673
NPI assigned
Jun 25, 2007
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD00047553 WA
Gastroenterology Physician 207RG0100X C55510 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010

Mailing address

1417 S Westgate Ave Apt 202
Los Angeles, CA 90025-5270

Other practice location 1

2202 S Cedar St
#310
Tacoma, WA 98405-2318
Phone (253) 383-8342

Other practice location 2

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

Other practice location 3

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

Other identifiers 2

IdentifierTypeStateIssuer
8489965MedicaidWA
MD00047553OtherWAWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO, HI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130719000425 CA Practitioner - Gastroenterology 7517051782 Reassigns benefits to 3 organizations
I20220317002067 CO Practitioner - Gastroenterology 7517051782 Reassigns benefits to 1 organization
I20220708003516 HI Practitioner - Gastroenterology 7517051782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Upper gastrointestinal (GI) endoscopy for acid reflux49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital Family Medicine CurrentSince Mar 4, 2024 Accepting new patients
Sonora Community Hospital Family Medicine Current Accepting new patients
The Queens Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 8, 2021 Accepting new patients
The Queen's Medical Center Current Accepting new patients
Queen Emma Clinics CurrentSince Jul 1, 2022 Accepting new patients
County of Santa Clara Current Accepting new patients
Sonora Community Hospital CurrentSince Mar 4, 2024 Accepting new patients
Sonora Community Hospital CurrentSince Mar 4, 2024 Accepting new patients
Sonora Community Hospital Current Accepting new patients
County of Santa Clara CurrentSince Jun 30, 2021 Accepting new patients
County of Santa Clara CurrentSince Jun 30, 2021 Accepting new patients
County of Santa Clara Past Accepting new patients
Western Washington Endoscopy Centers, LLC Past Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

680 Guzzi Ln
Ste 105
Sonora, CA 95370
Phone (209) 532-0126

680 Guzzi Ln
Ste 206
Sonora, CA 95370
Phone (209) 536-5760

1750 E Ken Pratt Blvd
Longmont, CO 80504
Phone (720) 718-7000

1925 Mountain View Ave
Longmont, CO 80501
Phone (303) 776-1234

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

Interoperability endpoints

  • Direct secure messaging: arezaie10548@cityofhope.direct-ci.com
  • Direct secure messaging: arezaie176095@santaclaravalley.direct-ci.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 1

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1821294000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 S WESTGATE AVE APT 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 S Cedar St",
            "address_2": "#310",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052318",
            "country_code": "US",
            "telephone_number": "253-383-8342",
            "fax_number": "253-404-0506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "910103012",
            "country_code": "US",
            "telephone_number": "626-256-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "910103012",
            "country_code": "US",
            "telephone_number": "626-256-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZAIE",
        "first_name": "ANAHITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00047553",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C55510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8489965",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "MD00047553",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.