Individual provider Active NPI

Amir H Hedayati-Rad, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Glendale, CA
National Provider Identifier
1861410029
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
A60239 Issued in CA
Practice address
706 W Broadway # 100
Glendale, CA 91204-1032
Phone
(818) 507-6404
Fax
(818) 507-6406
NPI assigned
Jul 17, 2006
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A60239 CA
Clinical Cardiac Electrophysiology Physician 207RC0001X A60239 CA Primary
Interventional Cardiology Physician 207RI0011X A60239 CA

Addresses

Primary practice location

706 W Broadway # 100
Glendale, CA 91204-1032

Mailing address

706 W Broadway # 100
Glendale, CA 91204-1032
Phone (818) 507-6404

Other practice location 1

930 W Main St
Barstow, CA 92311-2654
Phone (760) 256-1004

Other practice location 2

121 S 7th Ave Ste A
Barstow, CA 92311-3059
Phone (760) 818-4228

Other practice location 3

1245 Wilshire Blvd Ste 511
Los Angeles, CA 90017-4805
Phone (213) 855-1640

Other identifiers 3

IdentifierTypeStateIssuer
1659578110OtherCAGROUP NPI NUMBER
P00319921OtherCARAILROAD MEDICARE
00A602390MedicaidCA

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
I20040924000465 CA Practitioner - Cardiac ElectrophysiologyPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3971571332 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christo Cardiology and Vascular Medicine IncGroup PAC ID 0446794242, 8 clinicians
Priority Family Care Center ApcGroup PAC ID 3072922053, 9 clinicians
Ravindra Gautam MD IncGroup PAC ID 4082509229, 2 clinicians

Practice addresses (Care Compare)

15030 7TH St
Victorville, CA 92395-3811
Phone (213) 376-3762

201 S Alvarado St
Suite 321
Los Angeles, CA 90057-2354
Phone (213) 484-7800

2423 N Broadway
Los Angeles, CA 90031-2218
Phone (213) 376-3762

706 W Broadway
Suite 100
Glendale, CA 91204-1032
Phone (818) 507-6404

930 W Main St
Barstow, CA 92311-2654
Phone (818) 507-6404

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A60239CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vvipa Medical Group Inc CurrentSince Aug 15, 2022 Accepting new patients
Ravindra Gautam, M.D., Inc. CurrentSince May 1, 2020 Accepting new patients
Amir Hedayati-Rad M D Inc Cardiovascular Disease CurrentSince Apr 1, 2004 Accepting new patients
High Desert Medical Group Current Accepting new patients
Christo Cardiology & Vascular Medicine Inc Cardiovascular Disease CurrentSince Nov 26, 2024 Accepting new patients
Priority Family Care Center Apc Cardiovascular Disease CurrentSince May 11, 2024 Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
White Memorial Medical Center Past Accepting new patients

Locations

121 S 7th Ave
Ste A
Barstow, CA 92311
Phone (760) 818-4228

930 W Main St
Barstow, CA 92311
Phone 7602561004306

435 Arden Ave
Ste 330
Glendale, CA 91203
Phone (818) 507-6404

706 W Broadway
#100
Glendale, CA 91204
Phone (818) 507-6404

706 W Broadway
Ste 100
Glendale, CA 91204
Phone (818) 396-8300

1245 Wilshire Blvd
Ste 511
Los Angeles, CA 90017
Phone (213) 977-1246

1762 Westwood Blvd
Ste 110
Los Angeles, CA 90024
Phone (310) 441-2000

201 S Alvarado St
Ste 321
Los Angeles, CA 90057
Phone (213) 483-8464

2423 N Broadway
Los Angeles, CA 90031
Phone (213) 376-3762

850 S Atlantic Blvd
Ste 104
Monterey Park, CA 91754
Phone (213) 376-3762

12370 Hesperia Rd
Ste 2
Victorville, CA 92395
Phone (760) 245-4747

12408 Hesperia Rd
Ste 2
Victorville, CA 92395
Phone (760) 553-7000

15030 Seventh St
Victorville, CA 92395
Phone (213) 376-3762

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amir.hedayati-rad.1@28873.direct.athenahealth.com
  • Direct secure messaging: amir.hedayati-rad.1@32769.direct.athenahealth.com
  • Direct secure messaging: amir.hedayati.p2@direct.hvvmg.nextgenshare.com
  • Direct secure messaging: amir.hedayati.p7@direct.hvvmg.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1861410029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 W BROADWAY # 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041032",
            "telephone_number": "818-507-6404",
            "fax_number": "818-507-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 W BROADWAY # 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041032",
            "telephone_number": "818-507-6404",
            "fax_number": "818-507-6406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 W Main St",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112654",
            "country_code": "US",
            "telephone_number": "760-256-1004",
            "fax_number": "760-256-1055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 S 7th Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923113059",
            "country_code": "US",
            "telephone_number": "760-818-4228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1245 Wilshire Blvd Ste 511",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900174805",
            "country_code": "US",
            "telephone_number": "213-855-1640",
            "fax_number": "585-209-6318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDAYATI-RAD",
        "first_name": "AMIR",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A60239",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A60239",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A60239",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1659578110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00319921",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A602390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.