NPIMap

Individual provider Active NPI

Edward Rustamzadeh, M.D.

  • Neurological Surgery Physician
  • San Jose, CA
National Provider Identifier
1861453318
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A90229 Issued in CA
Practice address
393 Blossom Hill Rd Ste 295
San Jose, CA 95123-1654
Phone
(408) 540-6861
Fax
(408) 540-6865
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A90229 CA Primary

Addresses

Primary practice location

393 Blossom Hill Rd Ste 295
San Jose, CA 95123-1654

Mailing address

393 Blossom Hill Rd Ste 295
San Jose, CA 95123-1654
Phone (408) 540-6861

Other practice location 1

11190 Warner Ave
Suite 306
Fountain Valley, CA 92708-4019
Phone (612) 845-4695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060814000589 CA Practitioner - Neurosurgery 3971536921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2550 Samaritan Dr
Suite D
San Jose, CA 95124-4104
Phone (408) 540-6861

Hospital & facility affiliations

  • Good Samaritan Hospital Hospital, San Jose, CA, CCN 050380
  • El Camino Health Hospital, Mountain View, CA, CCN 050308
  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion140
Laminectomy or laminotomy (partial removal of spine bones)30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A90229CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Brain & Spine Institute, Inc Neurological Surgery CurrentSince Apr 24, 2006 Accepting new patients
Advanced Ep Diagnostics, Inc. CurrentSince Mar 21, 2018 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Stanford Health Care Neurological Surgery Past Accepting new patients
County of Santa Clara Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

11190 Warner Ave
Ste 306
Fountain Vly, CA 92708
Phone (714) 432-9990

800 Pollard Rd
Ste A
Los Gatos, CA 95032
Phone (408) 540-6861

2550 Samaritan Dr
Ste D
San Jose, CA 95124
Phone (408) 358-2666

393 Blossom Hill Rd
Ste 295
San Jose, CA 95123
Phone (408) 333-9350

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: erustamzadeh125979@santaclaravalley.direct-ci.net

Organizations & group practices 7

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 5

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1861453318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL RD STE 295",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231654",
            "telephone_number": "408-540-6861",
            "fax_number": "408-540-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL RD STE 295",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231654",
            "telephone_number": "408-540-6861",
            "fax_number": "408-540-6865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11190 Warner Ave",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927084019",
            "country_code": "US",
            "telephone_number": "612-845-4695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSTAMZADEH",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A90229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.