Individual provider Active NPI

Behdad Hamidi Ravari, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Laguna Hills, CA
National Provider Identifier
1881974699
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A130673 Issued in CA
Practice address
24452 Health Center Dr
Laguna Hills, CA 92653-3604
Phone
(949) 552-5572
Fax
(800) 756-8714
NPI assigned
Aug 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A130673 CA Primary

Addresses

Primary practice location

24452 Health Center Dr
Laguna Hills, CA 92653-3604

Mailing address

15642 Sand Canyon Ave Unit 54264
Irvine, CA 92619-5445
Phone (949) 836-2529

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
I20151106001401 CA Practitioner - Physical Medicine and Rehabilitation 2466762265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130673CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Physical Medicine & Rehabilitation Apc Physical Medicine & Rehabilitation CurrentSince Sep 16, 2015 Accepting new patients

Locations

15642 Sand Canyon Ave
Unit 54264
Irvine, CA 92619

33 Creek Rd
Ste 260
Irvine, CA 92604
Phone (949) 552-5572

24452 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 630-0584

25652 Old Trabuco Rd
Lake Forest, CA 92630
Phone (949) 380-9380

2929 Westminster Ave
Unit 3537
Seal Beach, CA 90740

Interoperability endpoints

  • Direct secure messaging: behdad.ravari@697311328272388.direct.elationemr.com
  • Direct secure messaging: bhamidiravani174118@direct.memorialcare.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1881974699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15642 SAND CANYON AVE UNIT 54264",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926195445",
            "telephone_number": "949-836-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24452 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533604",
            "telephone_number": "949-552-5572",
            "fax_number": "800-756-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVARI",
        "first_name": "BEHDAD",
        "middle_name": "HAMIDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A130673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.