Organization Active NPI

United California Surgical Forum Inc.

  • Surgery Physician
  • Madera, CA
National Provider Identifier
1861733974
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
112001 Issued in CA
Legal business name
UNITED CALIFORNIA SURGICAL FORUM INC.
Practice address
1000 E Almond Ave
Madera, CA 93637-5693
Phone
(559) 673-5657
Fax
(559) 549-9736
NPI assigned
Mar 14, 2013
Last updated
Mar 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Authorized official

Name
Dr. Rame D Iberdemaj, M.D.,NPI 1922294453
Title
President
Phone
(559) 673-5657

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 112001 CA Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X 112001 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208G00000X 112001 CA

Addresses

Primary practice location

1000 E Almond Ave
Madera, CA 93637-5693

Mailing address

1000 E Almond Ave # 3a
Madera, CA 93637-5693
Phone (559) 673-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130606000152 CA Part B Supplier - Clinic/Group Practice 5294973046 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA; Madera, CA

National Provider Directory

National Provider Directory

Locations

2940 Fresno St
Fresno, CA 93721
Phone (559) 673-5657

1000 E Almond Ave
#3A
Madera, CA 93637
Phone (559) 673-5657

1000 E Almond Ave
Ste 101
Madera, CA 93637
Phone (559) 673-5657

1000 E Almond Ave
Ste 102
Madera, CA 93637

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1861733974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E ALMOND AVE # 3A",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375693",
            "telephone_number": "559-673-5657",
            "fax_number": "559-549-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E ALMOND AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375693",
            "telephone_number": "559-673-5657",
            "fax_number": "559-549-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CALIFORNIA SURGICAL FORUM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "IBERDEMAJ",
        "authorized_official_first_name": "RAME",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-673-5657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "112001",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "112001",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "112001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.