Individual provider Active NPI

Talayeh Rezayat, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Fairfield, CA
National Provider Identifier
1841511409
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
20A12035 Issued in CA
Practice address
101 Bodin Cir
Fairfield, CA 94535-1809
Phone
(707) 423-2300
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23218 MS
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 20A12035 CA Primary

Addresses

Primary practice location

101 Bodin Cir
Fairfield, CA 94535-1809

Mailing address

101 Bodin Cir
Fairfield, CA 94535-1809
Phone (707) 423-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170605002516 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 4183870207 Reassigns benefits to 1 organization
I20251229001947 MO Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4183870207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4321 Washington St
Suite 6000
Kansas City, MO 64111-5930
Phone (816) 756-2255

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23218MSMDInternal Medicine Physician
20A12035CAMDCritical Care Medicine (Internal Medicine) Physician
12035CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Hospitalist Medical Group Inc Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Saint Luke'S Physician Group Inc Internal Medicine CurrentSince Dec 19, 2025 Accepting new patients

Locations

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12330 Metcalf Ave
Ste 420
Overland Park, KS 66213
Phone (913) 323-9000

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

4321 Washington St
Ste 6000
Kansas City, MO 64111
Phone (816) 756-2255

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 2

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841511409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAYAT",
        "first_name": "TALAYEH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23218",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "20A12035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.