Individual provider Active NPI

Taher Mir Saifullah, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Pasadena, CA
National Provider Identifier
1871939587
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A153944 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663
Phone
(626) 469-2939
Fax
(626) 469-2956
NPI assigned
May 21, 2013
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036143421 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X A153944 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663

Mailing address

625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663
Phone (626) 469-2939

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
I20180815003189 CA Practitioner - Pain Management 8224387881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Taher Saifullah MD a Professional Medical CorporationGroup PAC ID 0244648970, 3 clinicians

Practice addresses (Care Compare)

625 S Fair Oaks Ave
Suite 230
Pasadena, CA 91105-2663
Phone (626) 469-2939

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153944CAMDPain Medicine (Anesthesiology) Physician
036143421ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taher Saifullah MD a Professional Medical Corporation Multi-Specialty CurrentSince Feb 1, 2021 Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

625 S Fair Oaks Ave
Ste 230
Pasadena, CA 91105
Phone (626) 395-9588

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: taher.saifullah@3762.securemail.prognocis.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1871939587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 230",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052663",
            "telephone_number": "626-469-2939",
            "fax_number": "626-469-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 230",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052663",
            "telephone_number": "626-469-2939",
            "fax_number": "626-469-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAIFULLAH",
        "first_name": "TAHER",
        "middle_name": "MIR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036143421",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A153944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.