Organization Active NPI

Rheumatology Associates of Southern California

  • Rheumatology Physician
  • Santa Clarita, CA
National Provider Identifier
1871868299
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
RHEUMATOLOGY ASSOCIATES OF SOUTHERN CALIFORNIA
Practice address
23206 Lyons Avenue
Suite 106
Santa Clarita, CA 91321-2671
Phone
(661) 505-9901
Fax
(661) 505-9902
NPI assigned
Mar 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Dr. Amir Moldovan, M.D.NPI 1295777837
Title
President
Phone
(661) 505-9901

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

23206 Lyons Avenue
Suite 106
Santa Clarita, CA 91321-2671

Mailing address

23206 Lyons Avenue
Suite 106
Santa Clarita, CA 91321-2671
Phone (661) 505-9901

Other identifiers 1

IdentifierTypeStateIssuer
GC956AOtherCAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120606000758 CA Part B Supplier - Clinic/Group Practice 6002070802 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Clarita, CA

National Provider Directory

National Provider Directory

Locations

23206 Lyons Ave
Ste 106
Santa Clarita, CA 91321
Phone (661) 505-9901

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1871868299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23206 LYONS AVENUE",
            "address_2": "SUITE 106",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212671",
            "telephone_number": "661-505-9901",
            "fax_number": "661-505-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23206 LYONS AVENUE",
            "address_2": "SUITE 106",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212671",
            "telephone_number": "661-505-9901",
            "fax_number": "661-505-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHEUMATOLOGY ASSOCIATES OF SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "MOLDOVAN",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-505-9901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GC956A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.